Therapeutic Modalities Quiz 1

A patient with an acute lateral ankle sprain is referred for cryotherapy. Which patient factor is MOST important to review before initiating treatment?

A) History of hypertension

B) History of Raynaud’s disease

C) Current use of acetaminophen

D) Level of ankle swelling

Correct Answer: B) History of Raynaud’s disease

Rationale: Raynaud’s disease is a contraindication for cryotherapy due to an exaggerated vasoconstrictive response that may endanger tissue. Hypertension warrants monitoring, but is not an absolute contraindication. Acetaminophen use does not affect cryotherapy safety. Swelling guides treatment rationale, not treatment safety.

Reference: Cameron MH. Physical Agents in Rehabilitation: From Research to Practice. 4th ed. 2013: Pages: 135-137.

A patient with piriformis syndrome requires deep tissue heating to address muscle tightness. The clinician is deciding between 1 MHz and 3 MHz ultrasound. Which setting is MOST appropriate for this patient?

A) 1 MHz at 1.5 W/cm² for 10 minutes

B) 3 MHz at 1.0 W/cm² for 10 minutes

C) 1 MHz at 0.5 W/cm² for 5 minutes

D) 3 MHz at 1.5 W/cm² for 15 minutes

Correct Answer: A) 1 MHz at 1.5 W/cm² for 10 minutes

Rationale: 1 MHz ultrasound penetrates to a depth of up to 5 cm, which is necessary to effectively heat the piriformis muscle, and 1.5 W/cm² for 10 minutes produces an adequate thermal effect. 3 MHz only heats superficial tissues within 2 cm depth. The intensity and duration are too low to achieve meaningful heating. The parameters are excessive for superficial heating, increasing burn risk without benefit for deep tissues.

Reference: Cameron MH. Physical Agents in Rehabilitation: From Research to Practice. 4th ed. 2013: Pages: 187-190, 194.

A patient with a history of deep vein thrombosis presents for pneumatic compression therapy for lower extremity edema. Which examination finding is MOST important to obtain first?

A) Skin temperature

B) Limb girth measurements

C) Blood clot risk assessment

D) Capillary refill time

Correct Answer: C) Blood clot risk assessment

Rationale: Pneumatic compression is contraindicated in the presence of an active or recent deep vein thrombosis, due to the danger of embolization, making clot risk assessment critical. Skin temperature may reveal inflammation, but does not rule out a clot. Limb girth measurements track swelling but do not determine immediate safety. Capillary refill assesses circulation, but cannot exclude DVT.

Reference: Cameron MH. Physical Agents in Rehabilitation: From Research to Practice. 4th ed. 2013: Pages: 398-409.

A patient with right shoulder impingement receives iontophoresis with dexamethasone. Which polarity should be used for the active electrode?

A) Positive

B) Negative

C) Alternating

D) Biphasic

Correct Answer: B) Negative

Rationale: Dexamethasone is a negatively charged medication and must be delivered from the cathode (negative electrode) so that like charges repel and drive the drug into the tissue. positively charged drugs use the anode. Alternating polarity is not used for iontophoresis. Biphasic current is not applicable for medication delivery.

Reference: Cameron MH. Physical Agents in Rehabilitation: From Research to Practice. 4th ed. 2013: Page: 274.

A patient with chronic venous insufficiency is prescribed intermittent compression. Which of the following is the MOST appropriate inflation-to-deflation ratio?

A) 1:1

B) 2:1

C) 3:1

D) 4:1

Correct Answer: C) 3:1

Rationale: A 3:1 ratio mimics venous filling and optimizes fluid return for edema secondary to chronic venous insufficiency. Option A, B, and D are incorrect ratios and not used for edema, venous stasis, and DVT prevention. Option D can be used for residual limb reduction.

Reference: Cameron MH. Physical Agents in Rehabilitation: From Research to Practice. 4th ed. 2013: Page: 407-408.