CDM Final Test Correct 100%

IFC Basics - Answer - Carrier freq: Hz - Beat frequency: 1-200Hz - To sensory stimulation - Biphasic Waves IFC Indications - Answer - pelvic muscle weakness, OA pain, bone fracture healing, LBP, TMJ, PVD, shoulder pain, migraine, quad weakness, postsurgical knee pain IFC Contraindications - Answer - Anterior cervical region, Trans thoracic, Transcranially, Rate-responsive pacemakers or implanted cardioverter defibrillators, Abdomen/pelvis/lumbar during 1st trimester, Over metal implants. Epilepsy, Hemorrhagic area, Malignant region, Over damaged skin MES Basics - Answer - Pulsed or continuous DC current with max amp <1mA (1000μA) - Monophasic or Biphasic - 30-120 minutes (1-4x/day)/5-7days/wk MES Indications - Answer - dermal wounds, DOMS, epicondylitis, TMJ disorders, LBP, myocontracture, shoulder peritendinitis, trigger points MES Contraindications - Answer - Osteomyelitis area, Cancerous area, Electronic implants, Anterior cervical area (pulsed) ES/US Basics - Answer - Biphasic E-stim/Continuous US - Conventional:short duration (<150μS), high frequency (>80Hz) - Acupuncture: long duration (>150 μS), low frequency (<10Hz) - US: 1-3 mHz, treating area 1-4x head size. 100% for thermal, pulsed to reduce edema. Intensity 0.1-3 W/cm2 - 5-10 mins ES/US Indications - Answer - Must have Indication from both ES/US - ES: Pain - US: increase range, decrease pain, edema, inflammation ES/US Contraindications - Answer - Acute infections, CA (1* or 2*), Directly over SC, Over pregnant uterus, Over testes, Over thrombophlebitis, Over eyes, Intensity >3.0 W/cm2, Over heart, Over desensitized areas, Plastic/electronic implants, Caution over metal implants Russian Stim Basics - Answer - Continuous sine-wave bursts - Carrier frequency of 2500 Hz - Amplitude 40-60% MVC - Burst freq: 50Hz - On:Off—varies - Ramp: 1-2 seconds - Train with or without volition (synchronous/reciprocal/overlap) Russian Stim Indications - Answer - muscle weakness, post ACL reconstruction, post TKA, Bell's Palsy, Cerebral Palsy, knee OA, patellofemoral syndrome, post knee sprain mm atrophy and edema Russian Stim Contraindications - Answer - thoracic region, anterior cervical region, cranial region, epilepsy, over metal implants, hemorrhagic region, malignant region, Abdomen/pelvis/lumbar during 1st trimester, Rate-responsive pacemakers or implanted cardioverter defibrillators Iontophoresis Basics - Answer - DC current to drive med ions through hair follicles, sweat glands, "local dosing" - mA*min - 1-4 mA - Typically 1-80mA*min - Watch for skin bubbling (BAD) - Long slow dose=best - 10-30 mins Iontophoresis Indications - Answer - Inflammation, Edema reduction, Skin conditions (plantar wart, wound), Lymphedema, Scar Tissue, Calcified tendons Iontophoresis Contraindications - Answer - Sensory deficits, Recent scarring, Close metal implants, Acute injury with active bleeding, Near pacemakers/ICD Phonophoresis Basics - Answer - Ultrasound to push meds across skin - Stable Cavitation - Typically used with stationary sound head application, pulsed (50%) US delivery—preventing hotspot! - Superficial pathologies—3 mHz Phonophoresis Indications - Answer - Inflammation, Pain, Spasm, Loss of range, Edema, Sprains/strains, Bursitis, Tendonitis, Capsulitis Phonophoresis Contraindications - Answer - Allergy/intolerance to drug, Acute infections, CA (1* or 2*), Directly over SC, Over pregnant uterus, Over testes, Over thrombophlebitis, Over eyes, Intensity >3.0 W/cm2, Over heart, Over desensitized areas, Plastic/electronic implants, Caution over metal implants EMG Biofeedback Basics - Answer - EMG signal to give feedback of intrinsic muscle responses - Muscle Recruitment: decrease gain as muscle gets stronger - Muscle Inhibition: increase gain as muscle relaxes - 15-45 Min TENS(Biphasic) Basics - Answer - Pulsed biphasic current - Conventional: short duration (<150μS), high frequency (>80Hz) - Acupuncture: long duration (>150 μS), low frequency (<10Hz) - 30 mins TENS Biphasic Indications - Answer - Pain, Acute, subacute and chronic conditions TENS Biphasic Contraindications - Answer - Pacemakers (relative), Pregnant uterus, Trans cervical, Trans thoracic, Superficial metal implants, Undiagnosed pain, Malignancy, Active infections, Broken or abraded skin HVPC Basics - Answer - Pulsed, twin-peak monophasic pulses - Durations<200μs - Voltage 150-500 V - Polarity **Negative-inflammatory phase of wound healing **Positive-proliferative, remodeling and maturation phases - Frequency .1-200 Hz - 30-90 mins HVPC Indications - Answer - Pain reduction, Promote wound healing, Curb or reduce edema(especially acute), Enhancing motor performance HVPC Contraindications - Answer - Where active motion is contraindicated: fusion nonfixated fracture, or recently sutured nerves or tendons, Pacemakers, Metal implants, Active bleeding, Malignancies, Very disoriented patients, 1st trimester of pregnancy T/F. Guillian Barre Syndrome is caused by a viral event that sets off an autoimmune reaction? - Answer - True - Immune system attacks myelin sheath How is the diagnosis confirmed for GBS? - Answer - spinal tap for increased CSF protein levels Clinical Manifestations for GBS - Answer - rapid, symmetrical, ascending weakness - flaccid paralysis with hyporeflexia - 30% mechanical ventilation - 50% develop cranial nerve involvement - 50% have ANS symptoms - sensory symptoms - pain - muscle belly tenderness Prognosis for GBS - Answer - mortality 0-10% - recover strength 2-4 weeks after disease plateaus - 80% return to ambulation in 6 months - 15-20% dont fully recover muscle strength T/F. Resistance is contraindicated if MBT is present - Answer - True Physical Therapy Exam Components GBS - Answer - pain - muscle belly tenderness - severe: pain at rest - mod/min: no pain at rest, pain present w/squeezing - none: no pain w/squeezing - MMT - needs to be specific - must document small changes in MMT(+/-) - Fatigue - ROM - no stretch with MBT - Sensory test - distal to proximal - cranial nerve exam - respiratory function - functional mobility exam - disability scores for outcomes Goals of PT - GBS - Answer - depends on presentation of GBS - may include: improve respiratory function, optimize mm recovery for long term fxn, increase strength, prevent complications, patient education PT Interventions Acute Phase - GBS - Answer - protect weak muscles: analyze bed positioning, splints - ROM - point of pain except fingers and toes - Respiratory Care program - Bulbar training program PT Interventions Post Acute Phase - Mild MBT - GBS - Answer - ROM - selective mm groups: gentle stretch - Splinting - positioning and dynamic - Functional training program with equipment/assist - load proximal mm first, add activities one at a time, transfers PT Interventions Rehab Phase - GBS - Answer - W/C mobility - electric W/C or high back reclining, monitor tolerance and sitting angle, prevent orthostatic hypotension, AFO's - Transfers - begin w/sliding board after adequate W/C tolerance, progress to using UEs, LE WB, stand pivot - ambulation: upright tolerance, gait exam and orthotic prescrition SCI Functional Mobility Exam - Answer - bed mobility, sitting balance, transfers, W/C needs, W/C cushion needs, endurance to upright ASIA - Answer - American Spinal Injury Association What is neurological level? - Answer - most distal segment that has both sensory and motor function bilaterally What is motor level? - Answer - most distal segment of the spinal cord that has normal motor function bilaterally What is sensory level? - Answer - most distal segment of the spinal cord that has normal sensory function bilaterally What is the zone of partial preservation? - Answer - used with complete injuries - myotome/dermatome below neurological level that remains partially innervated What is considered a complete spinal cord injury? - Answer - No S4/S5 motor or sensory What does the SCI motor exam consist of? - Answer - 10 myotomes tested head to toe directionally What does the SCI sensory exam consist of? - Answer - 28 dermatomes on each side of body - testing for pin prick and light touch - Scoring: 0 - absent/1 - impaired/2 - normal Common Neuromuscular Complications with SCI - Answer - Spasticity - prolonged stretching, inhibitive casting, splinting, positioning, wt bearing - Autonomic dysreflexia - life or death situation - T6 and above