Modes of Heating
Whirlpool with the agitator on and Fluidotherapy are examples of this mode of heating. Besides providing superficial heat, what other benefit do these two physical agents provide?
Convection; desensitization
What are the frequency and duty cycle for a deep, thermal treatment?
1MHz, 100% duty cycle
Examples of target tissues
Muscle, synovial fluid, blood/circulation-high water content
The maximum force allowed on cervical traction; the maximum force allowed on lumbar traction.
30 pounds; 60% of body weight.
The number of units you bill for untimed physical agents.
1
Stages of cold a patient experiences with ice.
Intense cold, burning, aching, analgesia (pain relief)/numbness
Name two special spinal contraindications to thermal US and thermal diathermy? (Thermal US and thermal diathermy canNOT be used over the level of a...?)
Vertebroplasty or laminectomy
Mode of heating in which liquid turn into gas and an example
Evaporation-vapocoolant spray
Examples of target tissues
High collagen content-tendons, capsules, ligaments
Type of treatment used for wounds and acute injuries
Nonthermal
Ideal pt position if wanting to provide the greatest distraction forces to the lower lumbar/upper sacral regions.
Prone
Unlisted modality
97039
Why do patients remove rings before a paraffin treatment?
Metal has a high thermal conductivity and heats faster than skin and could cause a burn.
During an infrared treatment, the body produces more of this which causes an increase in circulation.
Nitrous oxide
Examples of physical agents that heat/cool by conduction
MHP, Paraffin, CP, cryocuff, WP with agitator off
Physiologically, what is happening in the treatment area if the duty cycle is 100%
Vasodilation, increased nerve conduction velocity, increased enzyme activity, and increased metabolism
The depth of shortwave reaching the tissues using the pads versus the drumhead.
1 inch versus 2 inches
Structural diseases of the spine, claustrophobia, conditions which may make the belts hazardous (osteoporosis, hiatal hernia), dentures, TMJ
Precautions to traction
Non wound diathermy
97024
How long after the use of a CP or MHP should a PTA wait before applying that same CP or MHP to a difference patient? (How long is the re-colling/warming process)
30 minutes
Skin is checked prior to superficial heat and cold and deep heat to ensure there is no what in the treatment area?
Heat-cuts (paraffin), bruising, metal (jewelry)
Cold-wounds
Heating method between two items of different temperatures in direct contact with one another and one is stationary while the other is moving.
Convection
CPT code for US for a wound? US/estim combo? Subthermal US for carpal tunnel? Thermal US to heat a tendon prior to stretch?
All 97035
Stretch window post thermal treatment
10-15 minutes
Hold/rest ratio and total treatment time for joint distraction
15 seconds on, 15 seconds off; 20-30 minutes
Traction
97012
Which contraindication to cold is defined as breaking out into a rash or hives after a cold treatment?
Cold hypersensitivity or cold induced uticaria
Other than superficial heat, name 2 physical agents in which there can be no metal in the treatment area.
Diathermy and Iontophoresis
Examples of physical agents that heat by conversion?
US and diathermy
Physiologically, what is occurring if the treatment parameters are 20% duty cycle, .5 W/cm2 intensity?
Creation of bubbles that oscillate, move linearly (cavitation and microstreaming) to massage cells causing increased cell membrane permeability (opening) to reduce edema
Physiologically, how does nonthermal diathermy work?
Uses electromagnetic energy to make certain cells more effective...such as fibroblasts, chondrocytes, etc.
The % of body weight needed for joint distraction in the cervical region. AND the % body weight for needed for joint distraction in the lumbar region.
7% for cervical; 50% for lumbar.
Paraffin
97018
The maximum temperature of the water allowed for a small, extremity whirlpool.
110 degrees Fahrenheit
What would be the parameters for US/estim combo for a patient with chronic trigger points in the bilateral upper trap, levator regions as well as through lower thoracic and upper lumbar paraspinals?
US-100% duty cycle, 1MHz freq, 1.5-2 W/cm2 for 1 minute per point
Estim-PreMod or HVPC at 1-10 Hz, pps
Soundhead is positive electrode while negative electrode placed proximal to treatment area.
Things that will increase the rate of conduction
Big difference in temperatures between two materials; large surface area; thermal conductivity difference; tissue thickness
I demonstrated the use of subthermal US for two special indications...one was underwater. What were the two indications?
acute flare up of RA; US to the GTOs to reduce increased muscle tone/spasticity
For a patient with a lower leg wound, where proximally could you place the diathermy drumhead to increase circulation?
Low back, anterior hip, behind the knee
(what if the pt had a laminectomy? THR? TKR?)
The angle between the table and the rope that pulls the cervical device for most cervical treatments.
25-30 degrees
97026
Infrared
Why are cold treatments usually less than 15 minutes?
Due to potential for reflexive vasodilation after 15 minutes.
What is the physiology behind contrast baths and what are a couple common indications for their use?
It is a vasomotor exercise (alternating vasodilation and vasoconstriction) for pts with c/o hand/foot stiffness such as with OA, RA.