Modalities Final

What are the three components of Evidence-Based Practice (EBP)?

• Best available evidence

• Clinical experience

• Patient preferences

What are the three components of clinical reasoning?

• Knowledge

• Cognition

• Metacognition

What is clinical decision making?

Using clinical reasoning and evidence-based practice to choose the safest and most effective treatment.

Therapeutic modalities produce physiological effects by transferring what?

Energy

What is an impairment?

Pain, swelling, weakness, decreased ROM

What is an activity limitation?

Difficulty performing tasks (walking, squatting, climbing stairs)

What is a participation limitation?

Unable to participate in sports, work, school, hobbies

What are environmental factors?

Outside influences (family support, transportation, equipment)

What are personal factors?

Age, motivation, fitness level, fear of reinjury

What does the Arndt-Schultz Principle state?

Too little energy = no effect

Too much energy = tissue damage

What does the Law of Grotthus-Draper state?

Only absorbed energy produces physiological changes.

What is the Inverse Square Law?

As distance increases, energy transfer decreases by the square of the distance.

What is the Cosine Law?

Maximum energy transfer occurs when the modality is perpendicular (90°) to the tissue.

Difference Principle?

Greater temperature difference = faster energy transfer.

Duration Principle?

Longer treatment = greater energy transfer.

What are the five types of pain?

• Nociceptive

• Neuropathic

• Nociplastic

• Psychological

• Motor (Biomechanical)

What is nociceptive pain?

Pain caused by actual or potential tissue damage.

What is neuropathic pain?

Pain caused by nerve damage.

What is nociplastic pain?

Pain caused by altered pain processing without tissue damage.

Which fibers transmit first pain?

A-delta fibers

Characteristics of first pain?

• Sharp

• Localized

• Fast

• Neocortical pathway

Which fibers transmit second pain?

C fibers

Characteristics of second pain?

• Dull

• Achy

• Burning

• Poorly localized

• Paleocortical pathway

Which neurotransmitter carries pain?

Substance P

Which neurotransmitter inhibits pain?

Enkephalin

What is Gate Control Theory?

A-beta fibers stimulate enkephalin release to block Substance P in the dorsal horn.

Which modalities use Gate Control Theory?

• TENS

• Heat

• Ice

• Massage

• Counterirritants

Healing phases in order?

1. Hemostasis

2. Inflammation

3. Proliferation

4. Remodeling

What happens during hemostasis?

• Vasoconstriction

• Platelet plug

• Coagulation cascade

• Fibrin clot

Major inflammatory mediators?

• Histamine

• Bradykinin

• Prostaglandins

• Cytokines

Which WBC arrives first?

Neutrophils

Which WBC arrives second?

Macrophages

Five cardinal signs of inflammation?

• Rubor

• Calor

• Tumor

• Dolor

• Functio Laesa

Causes of Rubor?

Vasodilation and increased blood flow.

Causes of Dolor?

Bradykinin, prostaglandins, swelling pressure.

Three goals of proliferation?

• Angiogenesis

• Granulation

• Re-epithelialization

Goal of remodeling?

Replace Type III collagen with Type I collagen.

What does Davis' Law state?

Soft tissue remodels along the lines of stress placed upon it.

Cryotherapy therapeutic skin temp

50–59°F (10–15°C)

Two reasons to use cryotherapy?

• Pain control

• Minimize secondary injury

Local effects of cryotherapy?

• Vasoconstriction

• Decreased metabolism

• Decreased nerve conduction

• Decreased muscle spasm

CBAN stands for?

Cold

Burning

Aching

Numb

Contraindications to cryotherapy?

• Raynaud's

• Cold urticaria

• Advanced diabetes

• PVD

• Poor circulation

• Anesthetic skin

When should heat be used?

Subacute and chronic injuries.

Two treatment goals of heat?

• Decrease pain

• Facilitate motion

What happens to collagen when heated?

Plastic deformation increases.

Best stretch after heating?

Slow, long-duration stretch.

Hydrocollator temperature?

160–170°F

Contraindications for heat?

• Acute injury

• Infection

• Tumor

• Fever

• PVD

• Decreased sensation

What is electrical current?

Flow of electrons.

What is electrical potential?

Electrical pressure (voltage).

Highest to lowest tissue impedance?

Skin/Adipose/Bone → Muscle → Blood/Nerves

Lowest to highest capacitance?

A-beta → A-alpha → A-delta → C fibers

What parameter overcomes capacitance?

Phase duration

Three factors of du Bois-Reymond?

• Amplitude

• Rate of change

• Duration

Sensory TENS parameters?

• 80–120 μs

• 80–120 pps

• A-beta

• 20–30 min

Motor TENS parameters?

• 200–300 μs

• <10 pps

• A-delta

• 30 min

NMES parameters?

• 250–400 μs

• 50–75 pps

• 1:5 duty cycle

• A-alpha

Russian current?

2500 Hz carrier

50 bursts/sec

IFC frequency?

4000–5000 Hz

Reverse piezoelectric effect?

Electrical energy → crystal vibration → sound waves.

1 MHz treats what depth?

Deep tissues (~5 cm)

3 MHz treats what depth?

Superficial tissues (~1–2 cm)

Temperature increases with ultrasound?

1°C = metabolism

2–3°C = blood flow

4°C = collagen extensibility

Ultrasound contraindications?

Pregnancy, cancer, pacemaker, DVT, fracture, eyes, heart, genitalia, spinal cord.

How does LLLT work?

Cytochrome c oxidase absorbs light → ATP production increases.

Three properties of laser?

• Monochromatic

• Coherent

• Collimated

Laser dosage units?

J/cm²

Lower laser dose is used for?

Pain relief

Higher laser dose is used for?

Tissue repair

Diathermy heats how deep?

3–5 cm

Capacitive vs Inductive?

Capacitive = adipose

Inductive = muscle (safer)

Massage sequence?

Effleurage → Pétrissage → Friction → Pétrissage → Effleurage

Four massage techniques?

• Effleurage

• Pétrissage

• Friction

• Tapotement

Physiological effects of massage?

Pain relief, blood flow, scar tissue mobilization, relaxation, flexibility.

Contraindications to massage?

Acute inflammation, fractures, infection, open wounds, thrombophlebitis.

What does BFR do?

Allows high-threshold motor unit recruitment with low-load exercise.

What does IPC do?

Moves edema proximally through forward propulsion.

What does CPM do?

Maintains joint motion after surgery.

What does ESWT do?

Stimulates healing in chronic tendinopathies.

What does vibration therapy do?

Improves neuromuscular activation.

What are the indications for traction?

• Herniated disc

• Radiculopathy

• Spinal stenosis

What does traction do?

Distracts vertebrae to reduce nerve root compression.

According to Virginia law, how long must adult medical records be kept?

10 years following the last patient encounter.

Which coding system describes a patient's diagnosis/pathology?

ICD-10

Which coding system is used for billing procedures?

CPT Codes

What law protects medical records?

HIPAA

What is informed consent?

The patient must understand the risks, benefits, alternatives, and voluntarily agree before treatment.

Failing to provide the standard of care is called what?

Negligence

What are the four parts of SOAP documentation?

• Subjective

• Objective

• Assessment

• Plan

Pasted text(7).txt

Document

Note Jun 1, 2026.pdf

PDF

Thanks! I can read it.

This PDF appears to be your Therapeutic Modalities study guide/infographic covering the first half of the course. It includes:

• Healing Process

  • Hemostasis

  • Inflammatory phase

  • Proliferation/Repair

  • Remodeling

  • The clotting, kinin, and complement cascades

  • Cardinal signs of inflammation (Rubor, Tumor, Dolor, Calor, Functio Laesa)

  • Angiogenesis, granulation, re-epithelialization

  • Type III → Type I collagen

  • Davis' Law and progressive loading

• Cryotherapy

  • Methods of conduction and convection

  • Physiological effects

  • Indications

  • Contraindications

  • CBAN (Cold → Burning → Aching → Numb)

• Thermotherapy

  • Conduction, convection, and conversion modalities

  • Physiological effects

  • Indications

  • Contraindications

  • Moist hot packs

  • Fluidotherapy

  • Paraffin bath

  • Contrast baths

  • Warm whirlpool

From everything you've shared over the last several weeks, this PDF covers many of the highest-yield concepts your instructor has tested repeatedly, especially the healing phases and thermal modalities. The diagrams on pages 1 and 2 are excellent visual summaries of the healing process, while pages 4–6 organize the major cryotherapy and thermotherapy concepts into easy-to-review charts.

I can also help you turn this into any of the following:

• A 1-page "cheat sheet" with only the facts most likely to be on your exam.

• 50 rapid-fire practice questions that mimic your professor's quiz style.

• A mock final exam (50–75 questions) using everything you've shared from this course.

• Flashcards for last-minute memorization.

Given all of the quizzes you've shown me, I think a mock final would be the best way to prepare.

Absolutely! Here is a comprehensive flashcard set based on everything you've studied this semester (your quizzes, professor's corrections, review sheets, and infographic). These are organized by unit so you can study efficiently.

---

UNIT 1: Evidence-Based Practice & Clinical Decision MakingFlashcard 1

Front: What are the three components of Evidence-Based Practice (EBP)?

Back:

• Best available evidence

• Clinical experience

• Patient preferences

---

Flashcard 2

Front: What are the three components of clinical reasoning?

Back:

• Knowledge

• Cognition

• Metacognition

---

Flashcard 3

Front: What is clinical decision making?

Back:
Using clinical reasoning and evidence-based practice to choose the safest and most effective treatment.

---

Flashcard 4

Front: Therapeutic modalities produce physiological effects by transferring what?

Back:
Energy

---

UNIT 2: ICF ModelFlashcard 5

Front: What is an impairment?

Back:
Pain, swelling, weakness, decreased ROM

---

Flashcard 6

Front: What is an activity limitation?

Back:
Difficulty performing tasks (walking, squatting, climbing stairs)

---

Flashcard 7

Front: What is a participation limitation?

Back:
Unable to participate in sports, work, school, hobbies

---

Flashcard 8

Front: What are environmental factors?

Back:
Outside influences (family support, transportation, equipment)

---

Flashcard 9

Front: What are personal factors?

Back:
Age, motivation, fitness level, fear of reinjury

---

UNIT 3: Energy Exchange PrinciplesFlashcard 10

Front: What does the Arndt-Schultz Principle state?

Back:
Too little energy = no effect

Too much energy = tissue damage

---

Flashcard 11

Front: What does the Law of Grotthus-Draper state?

Back:
Only absorbed energy produces physiological changes.

---

Flashcard 12

Front: What is the Inverse Square Law?

Back:
As distance increases, energy transfer decreases by the square of the distance.

---

Flashcard 13

Front: What is the Cosine Law?

Back:
Maximum energy transfer occurs when the modality is perpendicular (90°) to the tissue.

---

Flashcard 14

Front: Difference Principle?

Back:
Greater temperature difference = faster energy transfer.

---

Flashcard 15

Front: Duration Principle?

Back:
Longer treatment = greater energy transfer.

---

UNIT 4: Pain PhysiologyFlashcard 16

Front: What are the five types of pain?

Back:

• Nociceptive

• Neuropathic

• Nociplastic

• Psychological

• Motor (Biomechanical)

---

Flashcard 17

Front: What is nociceptive pain?

Back:
Pain caused by actual or potential tissue damage.

---

Flashcard 18

Front: What is neuropathic pain?

Back:
Pain caused by nerve damage.

---

Flashcard 19

Front: What is nociplastic pain?

Back:
Pain caused by altered pain processing without tissue damage.

---

Flashcard 20

Front: Which fibers transmit first pain?

Back:
A-delta fibers

---

Flashcard 21

Front: Characteristics of first pain?

Back:

• Sharp

• Localized

• Fast

• Neocortical pathway

---

Flashcard 22

Front: Which fibers transmit second pain?

Back:
C fibers

---

Flashcard 23

Front: Characteristics of second pain?

Back:

• Dull

• Achy

• Burning

• Poorly localized

• Paleocortical pathway

---

Flashcard 24

Front: Which neurotransmitter carries pain?

Back:
Substance P

---

Flashcard 25

Front: Which neurotransmitter inhibits pain?

Back:
Enkephalin

---

Flashcard 26

Front: What is Gate Control Theory?

Back:
A-beta fibers stimulate enkephalin release to block Substance P in the dorsal horn.

---

Flashcard 27

Front: Which modalities use Gate Control Theory?

Back:

• TENS

• Heat

• Ice

• Massage

• Counterirritants

---

UNIT 5: Healing ProcessFlashcard 28

Front: Healing phases in order?

Back:

1. Hemostasis

2. Inflammation

3. Proliferation

4. Remodeling

---

Flashcard 29

Front: What happens during hemostasis?

Back:

• Vasoconstriction

• Platelet plug

• Coagulation cascade

• Fibrin clot

---

Flashcard 30

Front: Major inflammatory mediators?

Back:

• Histamine

• Bradykinin

• Prostaglandins

• Cytokines

---

Flashcard 31

Front: Which WBC arrives first?

Back:
Neutrophils

---

Flashcard 32

Front: Which WBC arrives second?

Back:
Macrophages

---

Flashcard 33

Front: Five cardinal signs of inflammation?

Back:

• Rubor

• Calor

• Tumor

• Dolor

• Functio Laesa

---

Flashcard 34

Front: Causes of Rubor?

Back:
Vasodilation and increased blood flow.

---

Flashcard 35

Front: Causes of Dolor?

Back:
Bradykinin, prostaglandins, swelling pressure.

---

Flashcard 36

Front: Three goals of proliferation?

Back:

• Angiogenesis

• Granulation

• Re-epithelialization

---

Flashcard 37

Front: Goal of remodeling?

Back:
Replace Type III collagen with Type I collagen.

---

Flashcard 38

Front: What does Davis' Law state?

Back:
Soft tissue remodels along the lines of stress placed upon it.

---

UNIT 6: CryotherapyFlashcard 39

Front: Therapeutic skin temperature?

Back:
50–59°F (10–15°C)

---

Flashcard 40

Front: Two reasons to use cryotherapy?

Back:

• Pain control

• Minimize secondary injury

---

Flashcard 41

Front: Local effects of cryotherapy?

Back:

• Vasoconstriction

• Decreased metabolism

• Decreased nerve conduction

• Decreased muscle spasm

---

Flashcard 42

Front: CBAN stands for?

Back:
Cold

Burning

Aching

Numb

---

Flashcard 43

Front: Contraindications to cryotherapy?

Back:

• Raynaud's

• Cold urticaria

• Advanced diabetes

• PVD

• Poor circulation

• Anesthetic skin

---

UNIT 7: ThermotherapyFlashcard 44

Front: When should heat be used?

Back:
Subacute and chronic injuries.

---

Flashcard 45

Front: Two treatment goals of heat?

Back:

• Decrease pain

• Facilitate motion

---

Flashcard 46

Front: What happens to collagen when heated?

Back:
Plastic deformation increases.

---

Flashcard 47

Front: Best stretch after heating?

Back:
Slow, long-duration stretch.

---

Flashcard 48

Front: Hydrocollator temperature?

Back:
160–170°F

---

Flashcard 49

Front: Contraindications for heat?

Back:

• Acute injury

• Infection

• Tumor

• Fever

• PVD

• Decreased sensation

---

UNIT 8: Electrical ModalitiesFlashcard 50

Front: What is electrical current?

Back:
Flow of electrons.

---

Flashcard 51

Front: What is electrical potential?

Back:
Electrical pressure (voltage).

---

Flashcard 52

Front: Highest to lowest tissue impedance?

Back:
Skin/Adipose/Bone → Muscle → Blood/Nerves

---

Flashcard 53

Front: Lowest to highest capacitance?

Back:
A-beta → A-alpha → A-delta → C fibers

---

Flashcard 54

Front: What parameter overcomes capacitance?

Back:
Phase duration

---

Flashcard 55

Front: Three factors of du Bois-Reymond?

Back:

• Amplitude

• Rate of change

• Duration

---

Flashcard 56

Front: Sensory TENS parameters?

Back:

• 80–120 μs

• 80–120 pps

• A-beta

• 20–30 min

---

Flashcard 57

Front: Motor TENS parameters?

Back:

• 200–300 μs

• <10 pps

• A-delta

• 30 min

---

Flashcard 58

Front: NMES parameters?

Back:

• 250–400 μs

• 50–75 pps

• 1:5 duty cycle

• A-alpha

---

Flashcard 59

Front: Russian current?

Back:
2500 Hz carrier

50 bursts/sec

---

Flashcard 60

Front: IFC frequency?

Back:
4000–5000 Hz

---

UNIT 9: UltrasoundFlashcard 61

Front: Reverse piezoelectric effect?

Back:
Electrical energy → crystal vibration → sound waves.

---

Flashcard 62

Front: 1 MHz treats what depth?

Back:
Deep tissues (~5 cm)

---

Flashcard 63

Front: 3 MHz treats what depth?

Back:
Superficial tissues (~1–2 cm)

---

Flashcard 64

Front: Temperature increases with ultrasound?

Back:
1°C = metabolism

2–3°C = blood flow

4°C = collagen extensibility

---

Flashcard 65

Front: Ultrasound contraindications?

Back:
Pregnancy, cancer, pacemaker, DVT, fracture, eyes, heart, genitalia, spinal cord.

---

UNIT 10: Laser & DiathermyFlashcard 66

Front: How does LLLT work?

Back:
Cytochrome c oxidase absorbs light → ATP production increases.

---

Flashcard 67

Front: Three properties of laser?

Back:

• Monochromatic

• Coherent

• Collimated

---

Flashcard 68

Front: Laser dosage units?

Back:
J/cm²

---

Flashcard 69

Front: Lower laser dose is used for?

Back:
Pain relief

---

Flashcard 70

Front: Higher laser dose is used for?

Back:
Tissue repair

---

Flashcard 71

Front: Diathermy heats how deep?

Back:
3–5 cm

---

Flashcard 72

Front: Capacitive vs Inductive?

Back:
Capacitive = adipose

Inductive = muscle (safer)

---

UNIT 11: Manual Therapy & Mechanical ModalitiesFlashcard 73

Front: Massage sequence?

Back:
Effleurage → Pétrissage → Friction → Pétrissage → Effleurage

---

Flashcard 74

Front: Four massage techniques?

Back:

• Effleurage

• Pétrissage

• Friction

• Tapotement

---

Flashcard 75

Front: Physiological effects of massage?

Back:
Pain relief, blood flow, scar tissue mobilization, relaxation, flexibility.

---

Flashcard 76

Front: Contraindications to massage?

Back:
Acute inflammation, fractures, infection, open wounds, thrombophlebitis.

---

Flashcard 77

Front: What does BFR do?

Back:
Allows high-threshold motor unit recruitment with low-load exercise.

---

Flashcard 78

Front: What does IPC do?

Back:
Moves edema proximally through forward propulsion.

---

Flashcard 79

Front: What does CPM do?

Back:
Maintains joint motion after surgery.

---

Flashcard 80

Front: What does ESWT do?

Back:
Stimulates healing in chronic tendinopathies.

---

Flashcard 81

Front: What does vibration therapy do?

Back:
Improves neuromuscular activation.

---

Flashcard 82

Front: What are the indications for traction?

Back:

• Herniated disc

• Radiculopathy

• Spinal stenosis

---

Flashcard 83

Front: What does traction do?

Back:
Distracts vertebrae to reduce nerve root compression.

---

These 83 flashcards cover the high-yield concepts that consistently appeared in your quizzes, instructor corrections, and review materials, including the healing process, cryotherapy, thermotherapy, and other therapeutic modalities highlighted in your uploaded study guide.

Pasted text(8).txt

Document

This practice final is one of the best indicators of what your instructor thinks is important. Based on the questions, your previous quizzes, and the concepts that were repeated throughout the semester, here are additional flashcards covering everything that appeared on this exam. These are grounded in the content of the practice final you uploaded.

---

FINAL EXAM FLASHCARDS (Practice Final)Legal & DocumentationFlashcard 84

Front: According to Virginia law, how long must adult medical records be kept?

Back:
10 years following the last patient encounter.

---

Flashcard 85

Front: Which coding system describes a patient's diagnosis/pathology?

Back:
ICD-10

---

Flashcard 86

Front: Which coding system is used for billing procedures?

Back:
CPT Codes

---

Flashcard 87

Front: What law protects medical records?

Back:
HIPAA

---

Flashcard 88

Front: What is informed consent?

Back:
The patient must understand the risks, benefits, alternatives, and voluntarily agree before treatment.

---

Flashcard 89

Front: Failing to provide the standard of care is called what?

Back:
Negligence

---

Flashcard 90

Front: What are the four parts of SOAP documentation?

Back:

• Subjective

• Objective

• Assessment

• Plan

---

Front:During NMES for muscle reeducation, what should the patient do?

Contract along with the stimulation.

What stimulation level produces a visible muscle contraction without pain?

Motor-level stimulation

Electrically stimulated muscle contractions recruit fibers in what order?

• Large fibers first

• Fast-twitch fibers first

• Synchronous contractions

• Fatigue quickly

What three parameters determine the mode of TENS?

• Pulse frequency

• Pulse duration

• Current amplitude

Which pulse characteristics determine muscle contraction quality?

• Intensity

• Pulse frequency

• Phase duration

Which electrode setup uses two channels with four electrodes?

Quadripolar

For deeper stimulation, electrodes should be placed how?

Farther apart

Which current is used for iontophoresis?

Direct current (DC)

Sweep vs Scan in IFC?

• Sweep = changes frequency

• Scan = changes amplitude/location

Continuous ultrasound produces what effect?

Thermal heating