Thermal Agents and Therapeutic Ultrasound

physical agents

energy and materials applied to patients to assist in rehabilitation

List the three types of physical agents.

thermal
electromagnetic
mechanical

What are the type of physical agents

traction
compression
water
sound

List the two main effects of physical agents.

normalize motion
regulate muscle tone

main effect of physical agents - normalize motion

muscle weakness/recruitment
pain
soft tissue shortening

main effect of physical agents - regulate muscle tone

hypertonic
hypotonic

T/F: Reimbursement rates are generally not high using physical agents in class.

true

List factors of rate in heat transfer for conduction. (5)

temperature difference between the two surfaces
thermal conductivity
area of contact
thickness of tissue
time of exposure

List factors in convective heat exchange. (4)

temperature difference between two surfaces
area of exposure
rate of movement mass
time of exposure

convection

transfer of head by circulation or movement of another medium

List the factors of conversion heat exchange. (5)

intensity of conversion source
area of exposure
time of exposure
size of conversion applicator
not effected by the temperature of the agent

List the factors in radiant heat exchange. (4)

temperature difference between the two surfaces
area of exposure
distance of heat source
position of body part relative to parallel beams of radiation source

The following are classified as what type of therapeutic heat: hot packs, paraffin, electric heat pad

conduction

The following are classified as what type of therapeutic heat: whirlpool (HT), fluidotherapy

convection

The following are classified as what type of therapeutic heat: infrared lamp, short wave diathermy,

radiation

The following are classified as what type of therapeutic heat: ultrasound

conversion

Hemodynamic effects of superficial heat results in VASOCONSTRICTION/VASODILATION.

vasodilation

Hemodynamic effects; DIRECT/INDIRECT reflex action of smooth muscle vessels by cutaneous thermoreceptors.

direct

Hemodynamic effects of superficial heat; spinal cord reflexes are considered DIRECT/INDIRECT, INCREASING/DECREASING sympathetic adrenergic activation.

indirect, decreasing

neuromuscular effects of superficial heat; INCREASED/DECREASED nerve conduction velocity of myelinated nerves

increased

neuromuscular effects of superficial heat; INCREASED/DECREASED firing rate of demyelinated fibers

decreased

neuromuscular effects of superficial heat; INCREASED/DECREASED alpha motor neuron activity and decreased muscle spasm

decreased

neuromuscular effects of superficial heat; INCREASED/DECREASED firing rate of type II muscle spindles and gamma efferents

decreased

neuromuscular effects of superficial heat; INCREASED/DECREASED firing rate of type Ib from golgi tendon organs

increased

neuromuscular effects of superficial heat; INCREASED/DECREASED pain and muscle spasm

decreased

Gate Theory

the suggestion that only a certain amount of information can be processed by the nervous system at a given time
pain stimulation on C fibers and A-delta fibers moves slower than heat stimulation on A-beta fibers to the same synapse, temporarily blocking pain

metabolic effects of superficial heat; INCREASED/DECREASED metabolic rate

increased

metabolic effects of superficial heat; INCREASED/DECREASED oxygen availability

increased

metabolic effects of superficial heat; INCREASED/DECREASED healing rate

increased

metabolic effects of superficial heat; INCREASED/DECREASED collagenase activity that may contribute to destruction of articular cartilage

increased

What factors impact heat abstraction

Temperature difference between two surfaces
Thermal conductivity
Area of contact
Thickness of tissue
Time of exposure

evaporation

physical properties of cryotherapy
vapor coolant sprays include an alcohol that absorbs superficial heat and evaporates, removing heat

physiological effects of cold; hemodynamics response causes VASODILATION/VASOCONSTRICTION

vasoconstriction

physiological effects of cold; hemodynamics response causes INCREASED/DECREASED blood viscosity

increased

physiological effects of cold; hemodynamics response causes a(n) INDIRECT/DIRECT stimulation of smooth muscles of vessels

direct

physiological effects of cold; hemodynamics response causes INCREASED/DECREASED metabolism

decreased

The physiological effects of cold have an immediate response in superficial tissues within ___-___ minutes.

15-20

List the order of the action stage of cryotherapy. (4)

feeling of chilliness
lowering of skin temperature
vasoconstriction of peripheral vessels of skin
ischemia

List the order of the reaction stage of cryotherapy. (3)

feeling of warmth
gradual increase in skin temperature
hyperemia

Cold treatments are limited to ___ minutes or less.

15

another name for the reaction stage of cryotherapy

hunting phenomenon

physiological effects of cryotherapy; INCREASED/DECREASED pain threshold

increased

physiological effects of cryotherapy; INCREASED/DECREASED edema and inflammation

decreased

physiological effects of cryotherapy; INCREASED/DECREASED nerve conduction velocity

decreased

physiological effects of cryotherapy; INCREASED/DECREASED muscular spasm

decreased

physiological effects of cryotherapy - inflammation and edema control; INCREASED/DECREASED tissue temperature

decreased

physiological effects of cryotherapy - inflammation and edema control; INCREASED/DECREASED blood flow

decreased

physiological effects of cryotherapy - inflammation and edema control; INCREASED/DECREASED blood viscosity

increased

physiological effects of cryotherapy - inflammation and edema control; INCREASED/DECREASED capillary permeability;

decreased

physiological effects of cryotherapy - inflammation and edema control; INCREASED/DECREASED vasoactive substances/chemical mediators

decreased

How long does it take for cold dynamics to significantly cool the target tissue?

5-30

decreased secondary injury theory

theory where injury causes inadequate blood flow and oxygen
cells experience a decrease in metabolic rate
fewer "biochemical" mediators of tissue destruction are released
decreases tissue metabolism, restoring oxygen availability to meet demands

neuromuscular effects of cryotherapy; FACILITATES/INHIBITS muscle contractions in less than ___ minutes

facilitates, 5

neuromuscular effects of cryotherapy; INCREASED/DECREASED spasticity and strength within ___-___ minutes

decreased; 10-30

neuromuscular effects of cryotherapy; INCREASED/DECREASED gamma motor activity

decreased

neuromuscular effects of cryotherapy; INCREASED/DECREASED afferent spindle activity

decreased

List the 5 contraindications of heat.

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

List the 5 contraindications of cold.

cold hypersensitivity
cold intolerance
Raynaud's
regenerating peripheral nerves
circulation compromised or PVD

Sequence of sensation for cold application through ice massage

Occurs through stimulation of thermoreceptors, pain receptors, and then decreased signaling of the nerve

List the 5 stages of the sequence of sensation for cold application through ice massage.

intense cold
burning
aching
analgesia
numbness