Thermotherapy Uses
-Pain control
-Increase joint ROM
-Decrease joint stiffness
-Accelerated healing
-Infrared radiation for psoriasis
Thermotherapy Contraindications
-Hemorrhage
-Thrombophlebitis
-Impaired sensation/mentation
-Malignancy
-IR radiation of eyes
Thermotherapy Precautions
-Acute Injury/inflammation
-Pregnancy
-Impaired circulation
-Poor thermal regulation
-Edema
-Cardiac insufficiency
-Metal in area
-Open wounds
-Over topical counterirritants
-Demyelinated nerves
Hot Pack Parameters
-10-15 min
-6-8 layers of padding
Paraffin Parameters
-5-10 min (dip wrap method)
-6-10 layers of wax
Cryotherapy Uses
-Inflammation Control
-Edema Control
-Pain Control
-Spasticity of Muscles
-Facilitation
-Cyrokinetics/Cryostretch
-MS symptom management
Cryotherapy Contraindications
-Cold hypersensitivity
-Cold intolerance
-Cryoglobulinemia
-Paroxysmal cold hemoglobinuria
-Reynaud's Phenomenon
-Regenerating nerves
-Area of circulatory compromise
Cryotherapy Precautions
-Superficial main branch of nerve
-Open wound
-Hypertension
-Poor sensation/mentation
-Very young/very old
Cryotherapy Parameters
-Quick Ice= 3-5 sec
-Ice Massage= 5-10 minutes
-Cold Pack= 10-20 minutes (spasticity= 30 minutes)
Ultrasound Uses
-Soft tissue shortening
-Pain control
-Dermal ulcers
-Surgical skin incisions
-Tendon & ligament injuries
-Bone fractures
-Carpal tunnel syndrome
-Phonophoresis
Ultrasound Contraindications
-Malignancy (thermal)
-Pregnancy
-CNS tissue
-Joint cement
-Plastic components
-Pacemaker
-Thrombophlebitis
-Eyes
-Reproductive organs
Ultrasound Precautions
-Acute inflammation
-Epiphyseal plates
-Fractures
-Breast implants
Ultrasound Parameters
5-10 minutes (at least 8 minutes for Medicare billing)
Diathermy Uses
Thermal:
-Pain control
-Accelerated tissue healing
-Decrease joint stiffness
-Increase joint ROM
Non-Thermal:
-Pain & edema control
-Soft tissue, nerve, bone healing
-Improved osteoarthritis symptoms
Diathermy Contraindications
-Implanted or transcutaneous stimulators (pacemakers)
-Pregnancy
Thermal:
-Metal
-Malignancy
-Eyes
-Testes
-Growing epiphyses
Non-Thermal:
-Deep tissue/internal organs
-Substitute for conventional therapy for edema & pain
Diathermy Precautions
-Near electronic or magnetic equipment
-Obesity
-Copper bearing IUD
Non-Thermal:
-Pregnancy
-Skeletal immaturity
Electrical Stimulation Uses
-Improve strength/function
-Improve motor control
-CNS damage patients
-Spinal cord injury
-Stroke
-Muscle contractions for correcting biomechanics
-Reduce spasticity
Electrical Stimulation Contraindications
-Demand cardiac pacemaker
-Unstable arrhythmia
-Over carotid sinus
-Over venous/ arteriothrombosis (Thrombophlebitis)
-Pregnancy
Electrical Stimulation Precautions
-Cardiac disease
-Impaired sensation or mentation
-Malignancy
-Skin irritation/open wound
Laser Uses
-Soft tissue and bone healing
-Arthritis
-Lymphedema
-Neurological conditions
-Pain Management
Laser Contraindications
-Direct radiation of eyes
-Malignancy
-4-6 months after radiotherapy
-Hemorrhage
-Thyroid or other endocrine glands
Laser Precautions
-Low back or abdomen during pregnancy
-Epiphyseal plates in children
-Impaired sensation/mentation
-Photophobia/light sensitivity
-Pretreatment w/ photosensitizer
Mechanical Traction Uses
- Joint distractions
- Reduction of disc protrusions
-Soft tissue injuries
-Muscle relaxation
-Joint mobilizations
Mechanical Traction Contraindications
-Where motion is contraindicated
-Acute injury/inflammation
-Joint hypermobility or instability
-Peripheralization of symptoms with traction
-Uncontrolled hypertension
Mechanical Traction Precautions
-Structural diseases or conditions affecting the spine
-When pressure belts may be hazardous
-Displaced annular fragments
-Medical disc protrusion
-When severe pain fully resolves with traction
-Claustrophobia or other psychological aversion to traction
-
Mechanical Traction Parameters (Lumbar)
-Hold: 40% BW
-Off Time: 20% BW
-10 minutes
Mechanical Traction Parameters (Cervical)
-Hold: 12 lbs.
-Off Time: 6 lbs.
-15 minutes
Compression Bandage Uses
-Improve venous circulation
-Improve rate of healing of venous stasis ulcers
-Help prevent DVT
-Increases extravascular (external) hydrostatic pressure
-Residual limb shaping after amputation
-Control hypertrophic scarring
-Increase tissue temperature
Compression Bandage Contraindications
- Heart failure or pulmonary edema
- DVT, Thrombophlebitis, or pulmonary embolism
-Obstructed lymphatic or venous return
-Severe peripheral arterial disease or ulcers from arterial insufficiency
-Acute local skin infection
-Significant hypoproteinemia
-Ac
Compression Bandage Precautions
-Impaired sensation/mentation
-Uncontrolled hypertension
-Cancer
-Stroke/significant cerebrovascular insufficiency
-Superficial peripheral nerves
Types of Compression Bandages
-Compression bandages (single and multiple layers)
-Compression garments
-Velcro closure compression devices
-Intermittent pneumatic compression pump
Hydrotherapy Uses
-Superficial heating/cooling
-Water exercise
-Pain control
-Edema control
-Wound care
Hydrotherapy Contraindications - Local Immersion
-Maceration around wound
-Bleeding
Hydrotherapy Contraindications - Full Body
-Cardiac instability
-Infectious conditions that may spread by water
- Bowel/Incontinence
-Severe epilepsy
-Suicidality
Hydrotherapy Contraindications - Negative Pressure Wound
-Necrotic tissue
-Untreated osteomyelitis
-Malignancy in wound
-Untreated malnutrition
-Exposed vessels, nerves, organs
-Nonenteric /unexplained fistulas
-Exposed anastomotic sites
Hydrotherapy Precautions - Local Immersion
-Impaired thermal sensation in immersed area
-Infection in immersed area
-Confusion/impaired cognition
-Recent skin grafts
Hydrotherapy Precautions - Full Body (Very Warm/Hot Water)
-Pregnancy
-Multiple sclerosis
-Poor thermal regulation
Hydrotherapy Precautions - Full Body (Any Temp)
-Confusion/disorientation
-Alcohol ingestion
-Limited strength, endurance, balance, ROM
-Medications
-Urinary incontinence
-Fear of water
-Respiratory problems
Hydrotherapy Precautions - Nonimmersion
-Maceration
-May be ineffective
Hydrotherapy Precautions - Negative Pressure Wound Healing
-Anticoagulant therapy
-Difficult hemostasis
-Confusion, disorientation
Hydrotherapy Effects - Cleansing
-Softens materials
-Exerts pressure
-Debriding agent
Hydrotherapy Effects - Musculoskeletal
-Decrease weight bearing
-Resistance for strengthening
-Hydrostatic pressure increases resting muscle blood flow
Hydrotherapy Effects - Cardiovascular
-Enhanced venous return
-Central blood volume increases
-Cardiac volume increases
-Less HR response to exercise
Hydrotherapy Effects - Respiratory
-Increased chest wall compression
-Increased circulation in chest cavity
-Humidity reduces exercise-induced asthma
Hydrotherapy Effects - Renal
-Increased urine production
-Increased renal blood flow
-Increased central blood volume
-Decreased ADH and Aldosterone
Hydrotherapy Effects - Psychological
-Relaxing/Invigorating