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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


The science of therapeutic modalities

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


The science of therapeutic modalities

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



The science of therapeutic modalities

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 Characteristics

  • 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 Characteristics

  • 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 Characteristics

  • 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 Characteristics

  • 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 Characteristics

  • 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... Characteristics

  • Electrical Stimulating Currents

  • Shortwave And Microwave Diathermy

  • Infrared Modalities

    • Thermotherapy

    • Cryotherapy

  • Ultraviolet Radiation Therapy

  • Low-Power Lasers

  • Magnet Therapy


Electrical stimulating currents

Electrical Stimulating CharacteristicsCurrents


Electrical stimulating currents1
Electrical Stimulating Currents Characteristics

  • 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 Characteristics

  • Russian Currents

  • Interferential Currents


Electrical stimulating currents3
Electrical Stimulating Currents Characteristics

  • Russian Currents

  • Interferential Currents

  • Low-Volt Currents (Iontophoresis)


Electrical stimulating currents4
Electrical Stimulating Currents Characteristics

  • 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? Characteristics

  • 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? Characteristics

  • 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 Characteristics

  • 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 Characteristics

  • 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? Characteristics

  • 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? Characteristics

  • 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 Characteristics

  • 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 Characteristics

  • 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 CharacteristicsBe 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 Characteristics Modalities

  • Cold = Cryotherapy

  • Heat = Thermotherapy


Cryotherapy

Cryotherapy Characteristics


What should cryotherapy be used for
What Should Cryotherapy Be Used For? Characteristics

  • 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 Characteristics

  • Ice Bags or Ice Packs


Cryotherapy techniques1
Cryotherapy Techniques Characteristics

  • Ice Bags or Ice Packs

  • Ice Massage


Cryotherapy techniques2
Cryotherapy Techniques Characteristics

  • Ice Bags or Ice Packs

  • Ice Massage

  • Fluori-methane (Spray and Stretch)


Cryotherapy techniques3
Cryotherapy Techniques Characteristics

  • Ice Bags or Ice Packs

  • Ice Massage

  • Fluori-methane (Spray and Stretch)

  • Contrast Bath


Thermotherapy

Thermotherapy Characteristics


What should thermotherapy be used for
What Should Thermotherapy CharacteristicsBe 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 Characteristics

  • Hydrocollator Packs


Thermotherapy techniques1
Thermotherapy Techniques Characteristics

  • Hydrocollator Packs

  • Whirlpools


Thermotherapy techniques2
Thermotherapy Techniques Characteristics

  • Hydrocollator Packs

  • Whirlpools

  • Paraffin Baths


Thermotherapy techniques3
Thermotherapy Techniques Characteristics

  • Hydrocollator Packs

  • Whirlpools

  • Paraffin Baths

  • Fluidotherapy


Ultraviolet light therapy

Ultraviolet Light Therapy Characteristics


What can ultraviolet therapy be used for
What Can Ultraviolet Therapy Be Used For? Characteristics

  • 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


Laser therapy

LASER Therapy Characteristics


What are low power lasers used for
What Are Low-Power Lasers Used For? Characteristics

  • 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 therapy

Magnet Therapy Characteristics


Magnet therapy1
Magnet Therapy Characteristics

  • Despite Popularity No One Really Knows How They Work!!

  • Generally Thought To Be Safe


What are magnets used for
What Are Magnets Used For? Characteristics

  • Pain Modulation

  • Facilitate Strength

  • Explanations

    • Increased Circulation

    • Increased Temperature

    • Changes In pH

    • Reestablishing Normal Polarity Within The Injured Cell


Therapeutic ultrasound

Therapeutic Ultrasound Characteristics


Unlike other modalities ultrasound is acoustic energy

Unlike Other Modalities Ultrasound Is CharacteristicsAcoustic Energy


Ultrasound
Ultrasound Characteristics

  • Frequently Classified With Diathermy As A “Deep Heating” Modality

  • Mechanical Vibration

  • Sound Wave Trans-formed From High Frequency Electrical Energy


Acoustic energy
Acoustic Energy Characteristics

  • 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 CharacteristicsBe Used For?

  • Thermal Effects Particularly In Deeper Tissues

  • Non-Thermal Effects

    • To Enhance Healing At Cellular Level


Mechanical modalities

Mechanical Modalities Characteristics


Intermittent compression

Intermittent Compression Characteristics


Intermittent compression1
Intermittent Compression Characteristics

  • Mechanical Units That Create External Pressure

  • Facilitates Venous And Lymphatic Reabsorbtion Of Edema

  • Helps Decrease Pain & Increase ROM


Traction

Traction Characteristics


What should traction be used for
What Should Traction CharacteristicsBe 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 Characteristics

  • Manual Traction


Traction techniques1
Traction Techniques Characteristics

  • Manual Traction

  • Traction Machines


Traction techniques2
Traction Techniques Characteristics

  • Manual Traction

  • Traction Machines

  • Wall-Mounted Traction


Traction techniques3
Traction Techniques Characteristics

  • Manual Traction

  • Traction Machines

  • Wall-Mounted Traction

  • Inversion Traction


Massage techniques

Massage Techniques Characteristics


Massage
Massage Characteristics

  • Many Massage Techniques

    • Hoffa Massage

    • Acupressure/Shiatsu

    • Connective Tissue

    • Myofascial Release

    • Rolfing

    • Trager


What should massage be used for

Massage Has Effects On: Characteristics

Circulation And Lymphatic Flow

Nervous System

Muscles

Myofascia

Skin

Scar Tissue

Psychological Responses

Relaxation

Pain

What Should Massage Be Used For?