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The Science of Therapeutic Modalities

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The Science of Therapeutic Modalities. Legal Considerations. Athletic Trainers vs. Physical Therapists Chiropractors. When Do You Use Therapeutic Modalities?. For First Aid Immediately Following Injury Throughout The Injury Rehabilitation Process. Choices.

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Presentation Transcript
legal considerations
Legal Considerations
  • Athletic Trainers vs. Physical Therapists
  • Chiropractors
when do you use therapeutic modalities
When Do You Use Therapeutic Modalities?
  • For First Aid Immediately Following Injury
  • Throughout The Injury Rehabilitation Process
choices
Choices
  • Athletic Trainers Have A Choice Of A Variety of Therapeutic Techniques
  • Most All Athletic Trainers Eventually Choose To Use Therapeutic Modalities
  • How You Choose To Use A Therapeutic Modality Is An Individual Decision
  • The Choice Must Be Based On Theoretical Knowledge And Practical Experience
regardless of choice remember
Regardless of Choice Remember…..
  • When Using a Therapeutic Modality In Rehabilitation It Should Be Used ONLY As An Adjunct To Other Forms Of Therapeutic Exercise
how do we classify modalities
How Do We Classify Modalities?
  • Therapeutic Modalities Used By Athletic Trainers Can Be Classified As Being….
    • Electromagnetic
    • Acoustic
    • Mechanical
radiation
Radiation
  • Process By Which Energy In Various Forms Travels Through Space
  • Sunlight Is A Form Of Radiant Energy
  • Many Modalities Produce Radiant Energy
slide9

Spectrum

Red

Orange

Yellow

Green

Blue

Violet

Prism

electromagnetic radiations
Electromagnetic Radiations
  • Other Forms Of Radiation Other Than Visible Light May Be Produced When An Electrical Force Is Applied
slide11

Infrared

Spectrum

Red

Orange

Yellow

Green

Blue

Violet

Ultraviolet

electromagnetic radiations1
Electromagnetic Radiations
  • In Addition, Other Forms Of Radiation Beyond Infrared And Ultraviolet Regions May Be Produced When An Electrical Force Is Applied
  • These Radiations Have Different Wavelengths And Frequencies Than Those In The Visible Light Spectrum
slide14

Electromagnetic Spectrum

Longest

Wavelength

Lowest

Frequency

Electrical Stimulating Currents

Commercial Radio and Television

Shortwave Diathermy

Microwave Diathermy

Infrared

{

LASER

Visible Light

Ultraviolet

Shortest

Wavelength

Highest

Frequency

Ionizing Radiation

wavelength and frequency
Wavelength And Frequency
  • Wavelength-Distance Between Peak Of One Wave and Peak of the Next Wave
  • Frequency-Number Of Wave Oscillations Or Vibrations Per Second (Hz, CPS, PPS)
  • Velocity=Wavelngth X Frequency
electromagnetic radiations share similar physical characteristics
Electromagnetic Radiations Share Similar Physical Characteristics
  • Produced When Sufficient Electrical Or Chemical Forces Are Applied To Any Material
  • Travel Readily Through Space At An Equal Velocity (300,000,000 meters/sec)
  • Direction Of Travel Is Always In A Straight Line
electromagnetic radiations share similar physical characteristics1
Electromagnetic Radiations Share Similar Physical Characteristics
  • When Contacting Biological Tissues May Be…
electromagnetic radiations share similar physical characteristics2
Electromagnetic Radiations Share Similar Physical Characteristics
  • When Contacting Biological Tissues May Be…
    • Reflected
electromagnetic radiations share similar physical characteristics3
Electromagnetic Radiations Share Similar Physical Characteristics
  • When Contacting Biological Tissues May Be…
    • Reflected
    • Transmitted
electromagnetic radiations share similar physical characteristics4
Electromagnetic Radiations Share Similar Physical Characteristics
  • When Contacting Biological Tissues May Be…
    • Reflected
    • Transmitted
    • Refracted
electromagnetic radiations share similar physical characteristics5
Electromagnetic Radiations Share Similar Physical Characteristics
  • When Contacting Biological Tissues May Be…
    • Reflected
    • Transmitted
    • Refracted
    • Absorbed
laws governing the effects of electromagnetic radiations
Laws Governing The Effects of Electromagnetic Radiations
  • Arndt-Schultz Principle
    • No Changes Or Reactions Can Occur In The Tissues Unless The Amount Of Energy Absorbed Is Sufficient To Stimulate The Absorbing Tissues
laws governing the effects of electromagnetic radiations1
Laws Governing The Effects of Electromagnetic Radiations
  • Law Of Grotthus-Draper
    • If The Energy Is Not Absorbed It Must Be Transmitted To The Deeper Tissues
    • The Greater The Amount Absorbed The Less Transmitted and Thus The Less Penetration
laws governing the effects of electromagnetic radiations2
Laws Governing The Effects of Electromagnetic Radiations
  • Cosine Law
    • The Smaller The Angle Between The Propagating Radiation And The Right Angle, The Less Radiation Reflected And The Greater The Absorption

Source

Source

laws governing the effects of electromagnetic radiations3
Laws Governing The Effects of Electromagnetic Radiations
  • Inverse Square Law
    • The Intensity Of The Radiation Striking A Surface Varies Inversely With The Square Of The Distance From The Source

Source

1 Inch

2 Inch

electromagnetic modalities
Electromagnetic Modalities
  • The Majority of Therapeutic Modalities Used By Athletic Trainers Emit A Type Of Energy With Wavelengths And Frequencies That Can Be Classified As Electromagnetic Radiations
electromagnetic modalities include
Electromagnetic Modalities Include...
  • Electrical Stimulating Currents
  • Shortwave And Microwave Diathermy
  • Infrared Modalities
    • Thermotherapy
    • Cryotherapy
  • Ultraviolet Radiation Therapy
  • Low-Power Lasers
  • Magnet Therapy
electrical stimulating currents1
Electrical Stimulating Currents
  • All Can Be Classified As Transcutaneous Electrical Stimulating Currents
  • Electrical Muscle Stimulators (EMS)
  • Transcutaneous Electrical Nerve Stimulators (TENS)
  • Low Intensity Stimulators (LIS / MENS)
electrical stimulating currents2
Electrical Stimulating Currents
  • Russian Currents
  • Interferential Currents
electrical stimulating currents3
Electrical Stimulating Currents
  • Russian Currents
  • Interferential Currents
  • Low-Volt Currents (Iontophoresis)
electrical stimulating currents4
Electrical Stimulating Currents
  • Used Primarily For
    • Pain Modulation
    • Muscle Contraction
    • To Create Ion Movement
what can electrical stimulating currents be used for
What Can Electrical Stimulating Currents Be Used For?
  • Pain Modulation
    • Stimulation of sensory cutaneous nerves (Gate Control) at high frequency i.e. TENS
    • Production of B-endorphins at lower frequency i.e. Electroacutherapy
what can electrical stimulating currents be used for1
What Can Electrical Stimulating Currents Be Used For?
  • Producing Muscle Contraction, Relaxation, And Tetany
    • Depends On Type Of Current
      • Alternating (AC)
      • Direct (DC)
      • Polyphasic (Interferential)
    • Depends On Frequency (Russian Currents)
therapeutic uses of electrically induced muscle contraction
Therapeutic Uses Of Electrically Induced Muscle Contraction
  • Muscle Re-education
    • Biofeedback
      • Uses Surface EMG To Measure, Process, And Feedback Reinforcing Information Via Auditory Or Visual Signals
      • Helps Athlete Develop Greater Voluntary Control In Terms Of Either Neuromuscular Relaxation Or Muscle Re-education
therapeutic uses of electrically induced muscle contraction1
Therapeutic Uses Of Electrically Induced Muscle Contraction
  • Muscle Re-education
  • Muscle Pumping Contractions To Reduce Edema
  • Retardation Of Atrophy
  • Muscle Strengthening
  • Increasing Range Of Motion
what can electrical stimulating currents be used for2
What Can Electrical Stimulating Currents Be Used For?
  • Facilitating Soft Tissue And Bone Healing Through Biostimulative Effects
    • Subsensory Microamperage Currents (LIS)
what can electrical stimulating currents be used for3
What Can Electrical Stimulating Currents Be Used For?
  • Producing a Net Movement Of Ions Through The Use Of Continuous Low-voltage Currents That Elicit A Chemical Change In The Tissues (Iontophoresis)
diathermy
Diathermy
  • High Frequency Electromagnetic Energy
  • Cannot Depolarize Nerve or Muscle
  • Both SWD and MWD Used Primarily To Generate Heat In The Tissues
  • SWD Also Used For Nonthermal Effects
shortwave diathermy
Shortwave Diathermy
  • Generators Induce Magnetic And/Or Electrical Fields
  • May Be Either Continuous Or Pulsed
    • Continuous SWD Produces High Frequency Vibration Of Molecules In Tissues Generating Heat
    • Pulsed SWD Causes Repolarization In Damaged Cells Correcting Dysfunction
when should diathermy be used
When Should Diathermy Be Used?
  • If The Skin Or Some Underlying Soft Tissue Is Tender And Will Not Tolerate Pressure
  • In Areas Where Subcutaneous Fat Is Thick And Deep Heating Is Required
    • Pulsed SWD Produces The Same Magnitude And Depth Of Muscle Heating as 1MHz Ultrasound (Draper, JAT 1997)
  • When The Treatment Goal Is To Increase Tissue Temperatures In A Large Area
infrared modalities
Infrared Modalities
  • Cold = Cryotherapy
  • Heat = Thermotherapy
what should cryotherapy be used for
What Should Cryotherapy Be Used For?
  • To Decrease Local Temperature
  • To Decrease Local Metabolism
  • To Decrease Blood Flow (Vasoconstriction)
  • To Decrease Venous And Lymphatic Flow
  • To Decrease Nerve Conduction Velocity
  • To Decrease Muscle Excitability
  • Analgesia
cryotherapy techniques
Cryotherapy Techniques
  • Ice Bags or Ice Packs
cryotherapy techniques1
Cryotherapy Techniques
  • Ice Bags or Ice Packs
  • Ice Massage
cryotherapy techniques2
Cryotherapy Techniques
  • Ice Bags or Ice Packs
  • Ice Massage
  • Fluori-methane (Spray and Stretch)
cryotherapy techniques3
Cryotherapy Techniques
  • Ice Bags or Ice Packs
  • Ice Massage
  • Fluori-methane (Spray and Stretch)
  • Contrast Bath
what should thermotherapy be used for
What Should Thermotherapy Be Used For?
  • To Increase Local Temperature
  • To Increase Local Metabolism
  • To Increase Blood Flow (Vasodilation)
  • To Increase Venous And Lymphatic Drainage
  • To Increase Elasticity of Muscles & Ligaments
  • To Increase Nerve Conduction Velocity
  • To Increase Muscle Excitability
  • Analgesia
thermotherapy techniques
Thermotherapy Techniques
  • Hydrocollator Packs
thermotherapy techniques1
Thermotherapy Techniques
  • Hydrocollator Packs
  • Whirlpools
thermotherapy techniques2
Thermotherapy Techniques
  • Hydrocollator Packs
  • Whirlpools
  • Paraffin Baths
thermotherapy techniques3
Thermotherapy Techniques
  • Hydrocollator Packs
  • Whirlpools
  • Paraffin Baths
  • Fluidotherapy
what can ultraviolet therapy be used for
What Can Ultraviolet Therapy Be Used For?
  • Causes Chemical Changes In Skin That Have A Bactericidal Effect
  • Effects Are Primarily Superficial In Nature (<2mm)
  • To Treat A Variety Of Skin Lesions Including Acne, Folliculitis, Pityriasis, Tinea, Septic Wounds
  • Seldom Used In Treatment Because Of Availability Of Topical Agents
what are low power lasers used for
What Are Low-Power Lasers Used For?
  • Helium-Neon (HeNe) & Gallium-Arsenide (GaAs)
  • Produces No Thermal Effects
  • Soft-tissue And Fracture Healing
  • Pain Management
  • Not Approved By FDA For Therapeutic Use
magnet therapy1
Magnet Therapy
  • Despite Popularity No One Really Knows How They Work!!
  • Generally Thought To Be Safe
what are magnets used for
What Are Magnets Used For?
  • Pain Modulation
  • Facilitate Strength
  • Explanations
    • Increased Circulation
    • Increased Temperature
    • Changes In pH
    • Reestablishing Normal Polarity Within The Injured Cell
ultrasound
Ultrasound
  • Frequently Classified With Diathermy As A “Deep Heating” Modality
  • Mechanical Vibration
  • Sound Wave Trans-formed From High Frequency Electrical Energy
acoustic energy
Acoustic Energy
  • Cannot Travel Through Space
  • Relies On Molecular Collision For Transmission
  • More Dense Medium = Higher Velocity Of Travel
  • Depth Of Penetration Greater Than Any Form Of Electromagnetic Energy
what should ultrasound be used for
What Should Ultrasound Be Used For?
  • Thermal Effects Particularly In Deeper Tissues
  • Non-Thermal Effects
    • To Enhance Healing At Cellular Level
intermittent compression1
Intermittent Compression
  • Mechanical Units That Create External Pressure
  • Facilitates Venous And Lymphatic Reabsorbtion Of Edema
  • Helps Decrease Pain & Increase ROM
what should traction be used for
What Should Traction Be Used For?
  • To Treat A Variety Of Cervical And Lumbar Spine Problems
    • Creates Separation Of Vertebrae
    • Alters Proprioceptive Discharge Of Spine
    • Stretches Connective Tissue
    • Stretches Muscle
    • Improves Blood And Lymphatic Flow
    • Decreases Pressure On Disk
traction techniques
Traction Techniques
  • Manual Traction
traction techniques1
Traction Techniques
  • Manual Traction
  • Traction Machines
traction techniques2
Traction Techniques
  • Manual Traction
  • Traction Machines
  • Wall-Mounted Traction
traction techniques3
Traction Techniques
  • Manual Traction
  • Traction Machines
  • Wall-Mounted Traction
  • Inversion Traction
massage
Massage
  • Many Massage Techniques
    • Hoffa Massage
    • Acupressure/Shiatsu
    • Connective Tissue
    • Myofascial Release
    • Rolfing
    • Trager
what should massage be used for
Massage Has Effects On:

Circulation And Lymphatic Flow

Nervous System

Muscles

Myofascia

Skin

Scar Tissue

Psychological Responses

Relaxation

Pain

What Should Massage Be Used For?
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