True or False: Frequency and wavelength are inversely proportional
True
Low frequency electromagnetic radiation
-shortwaves
-microwaves
-IR radiation
-visible light
-uv light
Low Frequency EMR is...
Non-ionizing
High Frequency electromagnetic radiation
-x-rays
-gamma rays
High frequency EMR is...
Ionizing
Intensity of EMR is greatest when...
-energy output is HIGH
-source CLOSE to pt.
-beam is PERPENDICULAR
Clinical Effects of EMR are determined by...
radiation's frequency and wavelength range
Inrared (IR)
produced superficial heating w/o requiring direct contact
Visible Light
sunlight is the earliest form of EMR
UV radiation
produces erythema, tanning of skin, Vitamin D synthesis
Shortwave & micromwave energy
heat deep tissues; decreases pain, edema, facilitate tissue healing by non-thermal mechanisms
low-intensity laser & light
visible & near IR frequency ranges
-promote tissue healing, control pain & inflammation by non-thermal mechanisms
Physiological Effects of EMR
-can be thermal or non-thermal
-continuous = thermal (deep tissue)
-pulsed = non-thermal
-IR lamps used to heat superficial tissue
Non-thermal mechanisms of EMR
cause changes at a cellular level by altering...
-cell membrane function
-permeability
-intracellular function
promotes binding of chemicals
Non-thermal mechanisms of EMR accelerate synthesis and use of what?
ATP (energy molecule)
Arndt-Schulz Law
used to explain effects of law, non-thermal levels of EMR
-there is a certain min. stim. is needed to initiate a biological process
-Too much is bad
LASER
-monochromatic
-coherent
-directional
Monochromatic
(of light or other electromagnetic radiation) having only one wavelength
coherent
symmetrical wave
Divergent
Going in different directions
High intensity ("hot" laser)
used in surgery because
-sterile beam
-fine control
-cauterizes as it cuts
-produces less scarring
Types of Diodes
-LED (light emitting diode)
-SLD
-Laser Diode
SLD
-high intensity
-almost monochromatic
-Medium coherence
-Medium directionality
-Medium tx area/shorter application times
LED (one color)
-low intensity
-Not monochromatic
-Low coherence
-Low directionality
-large tx area
Laser Diodes
-High intensity
-Is monochromatic
-High coherence
-High directionality
-small tx area
Wavelength of Laser and Light
light w/longer wavelength (lower frequency) penetrates more deeply
Between ____ - ____ nm optimal depths of penetration in human tissue
600-1300 (red or IR)
IR penetrates ______ cm into soft tissue
2-4
Red light penetrates a few ____
mm
Power density of laser
mW/cm2
Most laser diodes used for therapy have a power of __mW
5-500
Laser effectiveness is greatest with...
-short-duration
-high power doses
Energy is measured in _____
Joules
Energy (J) =
Power (W) x Time (s)
Effects of Laser and Lights
-promotes ATP production
-promotes collagen production
-Modulate inflammation
-Inhibit Bacterial Growth
-Promote Vasodilation
-Alter Nerve Conduction Velocity and regeneration
Red laser and mitochondrial funtion and increase production of ATP by ____%
70
Clinical Indications for Laser & Light
-tissue healing (soft tissue and bone)
-Arthritis
-Lymphedema
-Neurological Conditions
-Pain management
Parameters for tissue healing w/laser and light
Red or IR @ 5-24 J/cm2
Arthritis w/laser and light
-increase grip strength and flexibility
-decrease swelling and pain
-improved function for cervial OA
Contraindications for Laser/light
-contact w/ eyes
-malignancy
-w/i 4-6 months after radiotherapy
-over hemorrhaging regions
-over thyroid or endocrine glands
Precautions for laser/light
-pregnancy
-epiphyseal plates (children)
-impaired senstation
-impaired memtaion
-photophobia (high sensitivity to light)
Adverse Effects of lasersq
-burning
-skin rash
-eye irritation
Documentation of laser use
-type of diode
-wavelength
-power
-area of body
-energy density
UVA (long wave)
produces fluorrescence in many substances
UVB (middle wave)
produces the most skin erythema
UVC (short wave)
germicidial
-filtered out by ozone
UV
produces non-thermal physiological effects
Intensity of UV reaching skin is highest when
-close to skin
-beam perpendicular to skin
Physiological Effects
-Vitamin D synthesis (helps w/bone formation)
-skin erythema (redness of skin)
-UVC is bacterial (wound care)
Vitamin D is good b/c...
-decreases BP
-improve blood glucose levels
-improves symptoms in MS and RA
Clinical Indications for UV
skin disorders
-Psoriasis
-acne
-scleroderma
-eczema
Contraindications for UV
-irradiation of the eyes
-skin cancer
-pulmonary tuberculosis
-cardiac, kidney, or liver
-lupus
-fever
Precautions for UV
-photosensitivity
-recent x-ray therapy
Adverse Effects of UV
-burning
-carciongenesis
-eye damage
Dose-Response Assessment
the process of characterizing the relationship between the dose of an agent administered or received and the incidence of an adverse health effect
Categories of Dose-Response Assessment
-suberythemal dose
-min. erythemal dose
-1st degree erythema
-2nd degree erythema
-3rd degree erythema
Documentation of UV
-if and how psoralen was given
-area of body
-type of UV
-Serial # of lamp
-distance b/w lamp and pt.
-tx duration
-response to tx
Thermal Conductivity
The ability of an object to transfer heat
Buoyancy
Ability to float
Resistance
The viscosity of water provides resistance to motion of the body in water
Hydrostatic pressure
Pressure exerted by a volume of fluid against a wall, membrane, or some other structure that encloses the fluid.
Physiological Effects of Hydrotherapy
-cleansing
-musculoskeletal
-cardiovascular
-respiratory
-renal
-psychological
Cleansing effects of hydrotherapy
-hydrating effects and friction of water to soften and remove foreign objects
Musculoskeletal effects of hydrotherapy
-unloads WB anatomical structures and can allow pt.s with load-sensitive joint
-pt.s with arthritis and obesity
Cardiovascular effects of hydrotherapy
-increases venous circulation
-increased cardiac output
-decreased HR & systolic BP asa respond to exercise
Use RPE (Borg) during hydrotherapy b/c ...
target hydrostatic pressure
Respiratory effects of hydrotherapy
-full body immersion increases work of breathing
-used to improve resp. strength
-water based exercises are often recommended for pt.s w/asthma
Renal effects of hydrotherapy
-effects can be taken advantage of in the tx of pts with hypervolemia, hypertension, peripheral edema
Uses of Hydrotherapy
-superficial heating/cooling
-water exercise
-pain control
-edema control
-wound care
Pros of heating/cooling w/hydrotherapy
-perfect contact
-doesn't need to be fastened
-allows for movement
Cons for heating/cooling w/hydrotherapy
-distal limbs are in a dependent position (may aggravate edema)
Hydrotherapy and Pregnancy
-thought to pose less risk to fetus than land-based exercise
Whirlpool
only used for cleansing wounds that contain
-necrotic tissue
-gross purulence
-dry eschar
Contraindications for Full Immersion
-cardiac instability
-infections
-bowel incontinence
-severe epilepsy
-suicidal pts
Precautions for Full Immersion
-pregnancy
-MS
-Poor thermal regulation
-urinary incontinence
-respiratory problems
Advantages of Contrast baths
-promote vigorous circulatory effect
V.A.C.
-used w/
-pressure ulcers
-diabetic foot wound
-large surgical wounds
Effects of Compression
-Improvement of venous and lymphatic circulation
-limits shape and size of tissue
-increase tissue temp.
Compression
A force that pushes on or squeezes a material.
_______ compression is more effective "milking" than single chamber intermittent compression
sequential
Clinical Indications for Compression
-Edema
-DVT
-Venous stasis ulcer
-Residual limb shaping after amputation
-control hypertrophic scarring (burn healing)
Lymphedema
Abnormal collection of fluid in tissue spaces caused by obstruction of lymph vessels and backflow of lymph.
Causes of Edema
-airline travel
-pregnancy
-other medical conditions
-phlebitis
-function of valves
static compression
utilizes bandaging and garments
intermittent compression
With a pneumatic device is primairly used t reduce chronic or post-traumatic edema and requires adjusting the parameters of inflation pressure, on/off ratio, and the total treatment time.
Contraindications for Compression
-heart failure
-acute DVT
-pulmonary embolus
-acute skin infection
-Peripheral artery disease (PAD)
Precautions for Compression
-impaired sensation
-uncontrolled hypertension
-cancer
-stroke
-superficial periph. nerves
resting pressure
elastic bandage exerts pressure whether pt is moving or immobile
working pressure
produced by active muscles pushing against inelastic bandages only when pt. is moving