Chapter 1. Therapeutic Modalities: What They Are and Why They Are Used
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Chapter 1. Therapeutic Modalities: What They Are and Why They Are Used. Working Hard Is Important. Working Smart Is More Important. What Are Therapeutic Modalities?. No text or dictionary has yet to define them. Therapeutic. Taber’s Cyclopedic Dictionary (1997;19:1934).

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No text or dictionary has yet to define them
No They Are Used text or dictionary has yet to define them.


Taber s cyclopedic dictionary 1997 19 1934

Therapeutic They Are Used

Taber’s Cyclopedic Dictionary (1997;19:1934)

  • Pertains to results obtained from treatment

  • Having medical or healing properties

  • A healing agent


Taber s cyclopedic dictionary 1997 19 1222

Modality They Are Used

Taber’s Cyclopedic Dictionary (1997;19:1222)

  • A method of application or the employment of any therapeutic agent

  • Limited usually to physical agents and devices

  • Any specific sensory stimulus such as taste, touch, vision, pressure, or hearing


Put it all together
Put It All Together They Are Used

  • Therapeutic modality:

  • A device or technique that delivers a physical agent to the body for therapeutic purposes


Physical agents
Physical Agents They Are Used

  • Heat

  • Cold

  • Light

  • Electricity

  • Exercise


What therapeutic purpose
What Therapeutic Purpose? They Are Used

To promote:

  • Wound healing

  • Pain relief

  • Flexibility and range of motion

  • Muscular strength

  • Muscular endurance


What therapeutic purpose cont
What Therapeutic Purpose? (cont.) They Are Used

To promote (cont.):

Muscular speed

Muscular coordination or skill

Power

Agility

Cardiorespiratory endurance


Classification of therapeutic modalities
Classification of Therapeutic Modalities They Are Used

  • Therapeutic modalities have been classified in many different ways.

  • But each is incomplete—that is,

  • none includes all modalities.


Classification of therapeutic modalities cont
Classification of Therapeutic Modalities (cont.) They Are Used

  • Mechanical: massage, mobilization, US, whirlpool

  • Cryotherapy: ice pack, immersion, ice massage

  • Thermotherapy: moist heat, dry heat, diathermy, US

  • Hydrotherapy: whirlpool, contrast bath, aquatic pool

  • Electrotherapy: muscle stimulation, TENS, diathermy

  • Active exercise


Selecting which therapeutic modality to use
Selecting Which Therapeutic Modality to Use They Are Used

  • Do you select?

  • Or does a physician select?


An isu physician s prescription
An ISU Physician’s Prescription They Are Used

  • Physical therapy for _____ because of pain and swelling of the left ankle and foot.


Brockport team physician
Brockport Team Physician They Are Used

  • Often prescribed diathermy,

  • but we didn’t have a diathermy machine




To select modality ies intelligently
To Select Modality(ies) Intelligently physical medicine and rehabilitation.

You must:

  • Have a correct diagnosis

  • Have a definite conception of the pathological and physiological changes associated with the injury


To select modality ies intelligently cont
To Select Modality(ies) Intelligently (cont.) physical medicine and rehabilitation.

  • Know what you want to accomplish with the modality—that is, have a therapeutic goal

  • Understand the modalities effects, indications, and contraindications

  • Match your therapeutic goal with a modality that will help you achieve that goal


Knobology
Knobology physical medicine and rehabilitation.

The study of application without theory


Art vs science theory vs application
Art vs Science physical medicine and rehabilitation.Theory vs Application


Rehabilitation and therapeutic modalities
Rehabilitation and Therapeutic Modalities physical medicine and rehabilitation.

  • To fully understand the role of therapeutic modalities you must:

    • Understand the overall rehabilitation process

    • Understand how each therapeutic modality fits into that process


  • See the physical medicine and rehabilitation.BIGPicture


What modality is used when
What Modality Is Used When? physical medicine and rehabilitation.


  • With a physical medicine and rehabilitation.systems approach, you must have a basis for choosing which therapeutic modality to use during various phases of rehabilitation.

  • Must match theproper therapeutic modality with the therapeutic goal.


Efficacy of modalities
Efficacy of Modalities physical medicine and rehabilitation.

Rate modalities for effect during rehabilitation.

  • Direct effect (good choice)

  • Effective if used in a specific way

  • Somewhat effective; not the best choice; there are better modalities for developing this element of rehabilitation


Modality efficacy summary
Modality Efficacy: Summary physical medicine and rehabilitation.

  • Traditional modalities (heat, light, sound, electricity) are used during only the first three phases.

  • Exercise is needed for most phases of rehabilitation.


Note physical medicine and rehabilitation.

  • Therapeutic exercise is not covered in this class, except for cryokinetics and cryostretch.


What rehabilitation is not
What Rehabilitation Is Not physical medicine and rehabilitation.

  • Treat then rehabilitate

  • Working with weights

  • A cookbook approach


Treat then rehabilitate
Treat Then Rehabilitate physical medicine and rehabilitation.

  • Treat with various therapeutic modalities (e.g., whirlpool, ultrasound) and then “rehabilitate”

    • Rehabilitation = the entire process of returning an injured athlete to competition


Working with weights
Working with Weights physical medicine and rehabilitation.

  • Concept too narrow

    • Rehabilitation = the entire process of returning an injured athlete to competition

    • Much more than strength training


A cookbook approach
A Cookbook Approach physical medicine and rehabilitation.

  • Stages or phases established with specific time periods and exercises

  • Optimal rehabilitation not planned by the calendar or by specific exercises


Re habilita tion
Re habilita tion physical medicine and rehabilitation.

  • Re again, anew, restore

  • habilitate to make suitable

  • habit characteristic condition of mind or body

  • tion the act of


Rehabilitation
Rehabilitation physical medicine and rehabilitation.

  • To restore to a normal or optimal state of health

    • For an athlete, to a high level of conditioning

  • Process of returning an athlete to a high level of conditioning


Rehabilitation cont
Rehabilitation (cont.) physical medicine and rehabilitation.

  • More than progressing through various phases of conditioning

  • For optimal results, rehabilitation must be planned and the plan executed systematically.


Rehabilitation cont1
Rehabilitation (cont.) physical medicine and rehabilitation.

  • For optimal results, you must consider:

    • Timing

    • Goals

    • Rate of progression

    • Criteria for progression

    • Psychological factors


Systems approach to total rehabilitation
Systems Approach to Total Rehabilitation physical medicine and rehabilitation.

  • Each patient and each injury is unique.

    • Based on signs, symptoms, and needs

      • Identify each phase of rehabilitation.

      • Establish criteria for developing each phase.

      • Carefully analyze the limitations imposed by the injury.

      • Determine which phase of rehabilitation to begin with.


Ten elements of rehabilitation
Ten Elements of Rehabilitation physical medicine and rehabilitation.

  • 1. Structural integrity

  • 2. Pain-free joints and muscles

  • 3. Joint flexibility

  • 4. Muscular strength

  • 5. Muscular endurance


Ten elements of rehabilitation cont
Ten Elements of Rehabilitation (cont.) physical medicine and rehabilitation.

  • 6. Muscular speed

  • 7. Muscular power (strength and speed)

  • 8. Skill patterns (integrated and coordinated movement 9. Agility (speed and skill)

  • 10. Cardiovascular endurance


Rehabilitation principles
Rehabilitation Principles physical medicine and rehabilitation.

  • The SAID principle

  • Therapeutic goals

  • Constant evaluation

  • Functional progression

  • Early exercise essential

  • Rate of reconditioning

  • Begin early, end late


The said principle
The SAID Principle physical medicine and rehabilitation.

  • Specific adaptation to imposed demands

  • dominates rehabilitation.

  • The body responds to a given demand witha specific and predictable adaptation.

  • Specific adaptation requires that specific demands be imposed.


The said principle cont
The SAID Principle (cont.) physical medicine and rehabilitation.

  • Each physical attribute must be identified and specifically trained for.

  • Optimize by using a goal-oriented approach.


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