NBCE Physiotherapy – NBS Questions and Answers correct

NBCE Physiotherapy – NBS Questions and Answers correct What are the contraindications to all modalities? "HIM" Hemorrhage Infection with suppuration Malignancy (except TENS) What are the contrainidcations to all healting? "DEAD EEA" Diabetes mellitus Encapsulated swelling Active TB Decrease thermal sensation Edema Abdomen or low back during pregnancy Acute conditions What are the contraindications to all electrical? Brain Eyes Heart Carotid sinuses Pacemaker Anesthesia (except HV) Pregnancy- low back except TENS Open wounds What is the timeframe for acute? Up to 72 hours What is subacute? Swelling is limited but debris and discoloration prevents healing Pumping is beneficial (alternative vasodilations and vasoconstrictions) (pumping also helps PVDs) What is the time frame for chronic? 2 weeks longer than anticipated What is the treatment of acute contidions? "PRICES" Protect Rest Ice Compression Elevate Support What are the types of AC currents (biphasic)? Sine Faradic Interferential What is the pulsatile wave forms for sine? Symmetrical (best contractor, no charge left in patient) What is the pulsatile wave form of faradic? Asymmetrical (sporadic) What is the pulsatile wave forms for interferential? 2 sine waves What are the types of DC currents (monophysic) Galvanic High volt What are the pulsatilve wave forms for galvanic? Make and break What is the pulsatile wave forms for high volt? Twin pulsed peak What does electrical treatments result in? Electrothermal Electrochemical Electrophysical What happens when there is an increase in frequency? Deeper penetration What happens when there is a medium frequency? Decreased skin impedance (best is to use a bigger electrode and increased voltage) What are the rules for pad placement? - Motor point or muscle belly: isolates the muscle (1 pad) Either side of the muscle belly: if the muscle is especially weak (2 pads) What is monopolar pads? Large area or trigger/acupuncture point - dispersal = large pad - active pad or pads = small pads What is bipolar pads? 2 pads for small muscle groups (AKA Pre-Mod) - dispersal and active pad are the equal size What is quadripolar pads? 4 pads in a crisscross pattern - Interferential or Russian Stim What are the EMS uses/names/duty cycles? Exercise/rehab: surge - 1:3 (normal), 1:5 (weak muscle) Fatigue/spasm: pulsed/tetanizing - 1:1 What frequency of EMS is used for pain? 1-20 endorphins, 70-150 enkephalin What is EMG used to treat? Muscle What is NCV used to test? Nerve What is cryotherapy used for? Vasoconstriction Anesthesia Pumping reaction (BAD) What is Hunting-Lewis reaction? "Pumping Reaction" process of alternating vasoconstriction and vasodilation due to over exposure of cold. (over 20 minutes) What is convection and examples? Transmission of heat in gases and liquids by circulation of heat particles Ex: Baths (hot and cold), Infrared What is radiation? Transmission of heat without the intervening medium getting warm Ex: Lamps, Medium Wave Diathermy, Infrared, Ultraviolet (does not heat air) What is conversion? The conversion of electrical energy into heat or mechanical energy Ex: Ultrasound (changes energy, reverse piezoelectric) What is conduction? The transfer of heat through a substance, often heating up a solid Ex: Ice, hydrocollator, paraffin, Infrared What does heat do in the circulation? Vasodilation increased blood flow increased edema What does cold do in the circulation? Vasoconstriction Decreased blood flow Decreased edema What is the role of heat on connective tissue? Decreased viscosity (thickness) Increased ability to stretch Decreased stiffness What is the role of cold on connective tissue? Increased viscosity (thickness) Decreased ability to stretch What is the role of heat on pain? Decreased Sedate What is the role of cold on pain? Decreased after an initial increase, numb (anesthesia) What is the role of heat on neuromuscular? Decreased muscle spasm, torticolis, tender points (FM) Decrease muscle strength Decreased endurance What is the role of cold on neuromuscular? Decreased spasticity, trigger points, MFS Increase/decrease strenght Decreased skilled motor tasks What are the results of cryotherapy? Local primary effects: decrease edema (vascular), anesthesia (neuro), increase pain tolerance. What are the indications of cryotherapy? headaches (migraines) urticaria (red wheals/hives) spasticity (trigger points) sprain/strain angiomas warts, herpes What are the contrainidcations of cryotherapy? Elderly and infants Hypersensitive to cold Vascular diseases (Raynauds) High blood pressure Chilblains and frostbite Tension headaches Spasm (fibromyalgia) What is the dosage of cryotherapy? Every 20 miuntes, each 2 waking hours What are the secondary reactions to cryotherapy? Cold Burning Aching Numb Hunting-lewis (pumping) - vasodilation (BAD) and vasoconstriction (20 minutes) What is the action of infrared? Thermal What is the results of infrared? - Vasodilation, decrease BP, increase blood and lymph flow, decrease spasm, phagocytosis - Erythema: redness or mottled skin - Erythema ab igne: mottled skin in area habitually exposed or one prolonged exposure (BAD) What are the indications for infrared? Musculoskeletal: synovitis, tendonitis, sprains/strains, bursitis, arthritis, torticolis Catarrhal: bronchitis, sinusitis, laryngitis, coryza Infections: furuncles, burns, ulcers Other: folliculitis, conjunctivitis, neuritis, bells palsy, raynauds What are the contraindications to infrared? Heat: pregnancy, DM, thermal sensitivity, active TB, encapsulated swelling, over metal, fair skin, contacts, fever, recent scar, skin rash What is the action of hydrocollator? Moist heat, decrease blood viscosity (CONDUCTION) What is the distance for hydrocollator? 6 layers of towels What is the duration of hydrocollator? 20-30 minutes What are the indications of hydrocollator? Tension headaches, prior to adjustments Fibromyalgia, spasm What are the contrainidcations of hydrocollator? Acute conditions, recent scars, fair skin Myofascial syndrome, trigger points Decreased circulation What are the results of contrast bath? Vasoconstriction/vasodilation (pumping action) CONVECTION What are the indications of contrast baths? Subacute connective tissue injuries, bruises, early PVDs, Raynauds, Buergers, DM What are the contraindications of contrast baths? Anesthesia, advanced arterial compromise, late PVDs What is the result of whirlpool baths? Relax, vasodilator, debridement (burns and abrasions) CONVECTION What is the time for whirlpool baths? 20-30 minutes What are the indications for whirlpool baths? Burns What are the contraindications for whirlpool baths? Increases BP, vascular compromise What is the time for sitz bath? 2-10 minutes CONVECTION What are the indications for sitz baths? Hemorrhoids, cystitis, dysmenorrhea, coccydynia, prostatitis, postpartum distress, constipation, urinary retention, sciatica What are the contrainidcations for sitz bath? Infertility (FOR MALES) What is the time for paraffin baths? 20 minutes What is the application for paraffin baths? Dip 7-10 times, wrap 20 minutes, active exercise Ratio 7:1 (Paraffin:mineral oil) CONDUCTION What are the indications of the paraffin bath? Chronic arthritis, hands, injured fingers What are the contrainidcations for paraffin bath? Acute arthritis, vascular compromise What is the action of fluidotherapy? Micromassage, thermal ("Dry Whirlpool") What is the results for fluidotherapy? Relaxation, vasodilator, sedation What is the indications for fluidotherapy? Chronic arthritis, amputee, strains, to increase ROM, RSDS, dystonia, open wounds What are the contraindications of fluidotherapy? Acute arthritis, vascular disease, skin infections, burns, young, old, implants What is the action of cold laser? Photobiomodulation, intracellular stimulation of mitochondrial activity What are the results of cold laser? Photobiostimulation - wound healing Photobioinhibition - pain management What are the indications of cold laser? (Almost anything): Open lesions, decubitus ulcers, DM ulcers, lacerations, burns, acute and chronic pain, bursitis, tendinitis decrease ROM, tic doulourenz irritation, fibromyalgia, trigger points What are the contraindications of cold laser Tattoo's, open growth plates, over the eyes, pregnant uterus, photosensitivity, medications, epilepsy, thick eschar, testicles Regions of: infection, dry skin, bruising, malignancies, pace maker, thyroid is the wavelength of cold laser? 630-1200nm (absorbs best into body rather than skin surface) What is the dosage of cold laser? 15-30 seconds over wound, minutes to hours for pain (usually 3-5 minutes) What gas is used in cold laser? Neon helium gases What is photophoresis? Chemical driven by light into treatment area What are the irreversible effects of cold laser? Protein coagulation, thermolysis and evaporation What are the results of ultraviolet? Vasodilation, bacteriocidal, photoaxis Erythema- local, due to histamine release Increases vitamin D synthesis (increase calcium) Improves skin and muscle tone, elasticity, secretory functions Stimulates metabolism Increases reticulocytes What are the indications of ultraviolet? Skin conditions- fungal, herpes zoster, dermatological conditions, burns, psoriasis, carbuncles, wounds, decubitus ulcers Bone conditions- rickets, osteomalacia What are the contraindications of ultraviolet? Hemorrhage, Infection, Malignancies, vascular disease, suppurative lesions, hemorrhage, tetracycline, SLE What is MED? Minimal erythemal dose What is erythema related to? Patient sensitivity Intensity vs distance (inverse square law) Angle of radiation (cosine law) What are the further treatments for erythemal patch test? As patient tolerance increases, increase duration by 15 sec/tx, to a max 3 minutes When this maximum has been reached, decrease the distance by 2 inches per treatment, approaching no closer than 18 inches What is the action of diathermy? Thermal (deep heat) What is the result of diathermy? Increases- temperature, pulse, respiration, BMR, lymph flow, elimination, nutrition, vasodilation, glandular secretions, endocrine changes Decreases- blood pressure, nerve pain, muscle cramps, muscle spasm What is the safety precautions used in diathermy? Diathermy unit must be 10 feet from any other electrical modality Diathermy treatments on individuals must be 4 feet from hearing aids, bridge work What are the indications of short wave diathermy? Deep muscle, thoracic cavity, bronchitis, joints, Pelvic Inflammatory Disease, prostatitis, sinusitis, algia, neuritis, amenorrhea, otitis media What are the contrainidcations of short wave diathermy? Pregnancy, casts, metal, hearing aids, contacts, wet skin, ulcers, pacemakers, advanced osteoporosis