Therapeutic Modalities

A. Chapter Objectives

a. Discuss the purpose of therapeutic modalities

b. Explain the legal implications associated with the use of therapeutic modalities

c. List the different types of modalities discussed in this chapter

i. Explain how they are used

d. Discuss several safety considerations involved with the use of therapeutic modalities.

e. Experience various modalities in a lab setting.

B. Key Terms

a. Cryotherapy

b. Diathermy

c. Electrical modality

d. Electrical muscle stimulation (EMS)

e. Fluidotherapy

f. Galvanic stimulation

g. Hydrocollator pack

h. Ice massage

i. Ice pack

j. Ice water immersion

k. Interferential stimulation (IFS)

C. Therapeutic Modalities

a. ______(blood flow) In the treatment of muscles and joints

b. To improve or restore an individual’s ______

c. Help regain ______and cope with ______

d. Help the injured regain the ability to engage in daily activities and athletic endeavors to his or her optimal performance level

D. Legal Implications Associated with Using Therapeutic Modalities

a. Therapeutic modalities

i. Provide great benefits in the rehabilitative process

ii. ______

b. Regulations

i. States vary as to what procedures the athletic trainers can perform

ii. Athletic trainers must be aware of individual state laws

iii. Essential to document all therapeutic treatments to ______of care and track ______

iv. Documentation can be used as a part of a defense in a ______

E. Choosing a Modality

a. There is a wide range of therapeutic modalities to choose from to achieve the best results

b. Will the choice be exercise, applications of heat, cold, electrical or mechanical stimulation?

c. Three factors when treating an injury:

i. Is it ______for use on this type of injury?

ii. Will modality ______to rehabilitation and total recovery for the person?

iii. Is the person applying the modality ______to do this procedure safely and efficiently?

F. Temperature Variation Modalities

a. ______

i. Modalities that use heat to manipulate circulation in the muscle tissues

b. ______

i. Modalities that use cold

G. Cryotherapies

a. To reduce the temperature of the body tissues in order to decrease blood flow to an area (______)

b. For ______

H. Thermotherapies

a. Use heat to increase the temperature of the body to increase blood flow to the tissues (______)

I. Cooling or Heating the Body

a. Conduction:

i. Method of heat transfer by ______with another medium

1. ______

b. Convection:

i. Method of heat transfer ______through a secondary medium

1. ______

c. Radiation:

i. Heat transfer by or from its source to the surrounding environment in the form of waves or rays

1. ______

d. Conversion:

i. ______through sound, electricity or chemicals

1. ______

e. Evaporation:

i. Heat transfer that takes place when a ______is converted to a gas

1. ______

J. Guides for Cryotherapy

a. Never apply any form of cold:

i. On an open wound without a protective covering

ii. To anesthetized skin. WHY?

b. Do not apply cryotherapy to patients with decreased circulation, diabetes, or cardiac conditions

c. Raynaud’s Phenomenon

i. Do not use cold therapy if a patient has an allergy to cold causing restriction of arterial blood flow

K. Applying Cryotherapy

a. Ice bags

b. Ice massage

c. Vapo-coolant sprays

d. Ice water immersion

e. Whirlpool baths with cooled water

f. Contrast baths alternating heat and cold

L. Types of Thermotherapy

a. Heat therapies

i. Provide comfort by increasing circulation and decreasing ______.

b. Types include:

i. ______

ii. ______

iii. Fluid therapy

iv. Paraffin baths

v. ______

M. Guidelines for Thermotherapy

a. Never apply heat to:

i. An area where any loss of sensation exists

ii. Immediately after an injury, which can cause swelling

iii. To the eyes or genitalia

iv. To the abdomen if the patient could possibly be pregnant

v. An open wound, burn, or over a cancerous area

vi. Patients with a history of reduced thermal regulation or diabetes

N. To avoid further injury to tissues,

a. always ______the time for which thermotherapy is applied

b. using proper ______.

O. Electrical Modalities

a. Use electricity to influence healing

i. Stimulate body tissues to speed their healing

ii. Electrical modalities ______into the tissues than other methods

iii. Among the most effective ways of decreasing healing time

b. Low voltage stimulation can help ______

c. High voltage stimulation is used to ______

P. Guidelines for Electrical Modalities

a. Follow the physician or therapist’s orders for all electrical modalities

b. Make sure equipment works properly

i. Plugged in

ii. Powered through a circuit served by a ground fault interrupter

c. ______

d. Expose and cleanse the area to be treated with soap and water or alcohol

e. Dry it thoroughly so that electrodes will stick to the skin

f. Place electrode pads according to manufacturer’s instruction

g. Avoid prolonged point contact when using ultrasound

h. Follow the manufacturer’s instructions for use of all equipment

i. ______

j. Turn treatment channels off before carefully removing the adhesive electrodes from the patient’s skin

k. Leave the treatment area clean when finished

l. Follow manufacturer’s instructions to ______and ensure safe use of the unit

m. Never use electrical modalities on a open wound

n. Do not use this modality for a patient with a pacemaker without the physician’s permission

o. Avoid high fluid areas of the body

p. Do not use electrical modalities over the carotid arteries

q. Electrical modalities should not be used on the trunk of anyone pregnant

r. Stop treatment if the patient has ______with the treatment

Q. Types of Electrical Modalities

a. Ultrasound therapy

b. Electrical muscle stimulation (EMS)

c. Galvanic stimulation

d. Interferential stimulation (IFS)

e. Iontophoresis

f. Transcutaneous electrical nerve stimulation (TENS)

g. Diathermy

R. Mechanical modalities

a. Assist in healing by exerting pressure to the soft tissues, increasing circulation and/or distracting (pulling) bony structures

b. This pressure can be applied manually or with a device

S. Guidelines

a. Follow manufacturer’s instructions for all equipment

b. Frequently check circulation

c. Stop treatment if the patient’s pain increases

T. Types of Mechanical Modalities

a. ______

b. ______

c. ______