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Therapeutic Modalities in Rehabilitation

ISBN: 9780071441230 | 0071441239
Edition: 3rd
Format: Hardcover
Publisher: McGraw-Hill Medical
Pub. Date: 5/18/2005

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SummaryTable of ContentsAuthor Biography
The most comprehensive therapeutic modalities book. Provides a theoretically based but practically oriented guide to the use of therapeutic modalities. Perfect for the required course in the Physical Therapy curriculum or as a clinical reference, the text features extensive use of case studies, laboratory activities, and a renown illustration program.
Contributorsxvii
Prefacexix
Part One Foundations of Therapeutic Modalities
The Science of Therapeutic Modalities
3... MORE
Wiiliam E. Prentice
Radiant Energy
3(1)
Electromagnetic Radiations
4(2)
Wavelength and Frequency
6(1)
Laws Governing the Effects of Electromagnetic Radiations
6(2)
Arndt-Schultz Principle
6(1)
Law of Grotthus-Draper
7(1)
Cosine Law
7(1)
Inverse Square Law
8(1)
The Application of the Electromagnetic Spectrum to Therapeutic Modalities
8(3)
Electrical Stimulating Currents
9(1)
Electromyographic Biofeedback
9(1)
Shortwave and Microwave Diathermy
9(1)
Infrared Modalities
9(1)
Laser
10(1)
Ultraviolet Light
10(1)
The Acoustic Spectrum and Ultrasound
11(3)
Extracorporeal Shock Wave Therapy (ESWT)
11(1)
Summary
12(2)
The Healing Process and Guidelines for Using Therapeutic Modalities
14(14)
William E. Prentice
Understanding the Healing Process
15(6)
Inflammatory-Response Phase
15(2)
Fibroblastic-Repair Phase
17(1)
Maturation-Remodeling Phase
18(2)
Factors That Impede Healing
20(1)
Injury Management Using Modalities
21(3)
Initial Acute Injury Phase
21(2)
Inflammatory-Response Phase
23(1)
Fibroblastic-Repair Phase
23(1)
Maturation-Remodeling Phase
24(1)
Other Considerations in Treating Injury
24(1)
Indications and Contraindications
25(3)
Summary
26(2)
The Role of Therapeutic Modalities in Wound Healing
28(32)
Pamela E. Houghton
Superficial Hot and Cold
28(1)
Hydrotherapy
29(1)
Electrical Stimulation
30(7)
Ultrasound
37(3)
Laser
40(2)
Ultraviolet Light
42(3)
Pneumatic Compression Therapy
45(1)
Choosing the Best Modality for the Treatment of Delayed or Nonhealing Wounds
45(3)
Indications, Contraindications
45(3)
Review of Clinical Research Evidence
48(3)
Algorithm for Choosing the Appropriate Therapeutic Modality
51(9)
Summary
53(7)
Managing Pain with Therapeutic Modalities
60(23)
Craig R. Denegar
Phillip B. Donley
Understanding Pain
60(1)
Types of Pain
61(1)
Pain Assessment
61(4)
Pain Assessment Scales
62(3)
Tissue Sensitivity
65(1)
Goals in Managing Pain
65(1)
Pain Perception and Neural Transmission
65(1)
Sensory Receptors
65(1)
Neural Transmission
66(4)
Facilitators and Inhibitors of Synaptic Transmission
67(2)
Nociception
69(1)
Neurophysiologic Explanations of Pain Control
70(5)
Blocking Pain Impulses with Ascending A-Beta Input
71(1)
Descending Pain Control Mechanisms
72(1)
Beta-Endorphin and Dynorphin
73(1)
Summary of Pain Control Mechanisms
74(1)
Cognitive Influences
74(1)
Pain Management
75(8)
Summary
77(6)
Part Two Electrical Modalities
Basic Principles of Electricity
83(21)
William E. Prentice
Components of Electrical Currents
84(1)
Electrotherapeutic Currents
85(2)
Generators of Electrotherapeutic Currents
86(1)
Waveforms
87(7)
Waveform Shape
87(1)
Pulses Versus Phases and Direction of Current Flow
87(2)
Pulse Amplitude
89(1)
Pulse Charge
90(1)
Pulse Rate of Rise and Decay Times
90(1)
Pulse Duration
91(1)
Pulse Frequency
91(1)
Current Modulation
92(2)
Electrical Circuits
94(2)
Series and Parallel Circuits
94(2)
Current Flow Through Biologic Tissues
96(1)
Physiologic Responses to Electrical Current
96(1)
Safety in the Use of Electrical Equipment
97(7)
Summary
99(5)
Electrical Stimulating Currents
104(61)
Daniel N. Hooker
Physiologic Response to Electrical Currents
105(16)
Muscle and Nerve Responses to Electrical Currents
106(5)
The Effects of Electrical Stimulation on Nonexcitable Tissues and Cells
111(10)
Electrical Concepts: Effects of Changes in Current Parameters and Their Effect on Treatment Protocols
121(6)
Biphasic Versus Monophasic Current
121(1)
Tissue Impedance
122(1)
Current Density
122(1)
Frequency
123(1)
Intensity
124(1)
Duration
124(1)
Polarity
125(1)
Electrode Placement
126(1)
Therapeutic Uses of Electrically Induced Muscle Contraction
127(7)
Muscle Reeducation
128(1)
Muscle Pump Contractions
129(1)
Retardation of Atrophy
129(2)
Muscle Strengthening
131(1)
Increasing Range of Motion
131(1)
The Effect of Noncontractile Stimulation on Edema
132(2)
Stimulation of Denervated Muscle
134(1)
Treatment Parameters for Stimulating Denervated Muscle
135(1)
Therapeutic Uses of Electrical Stimulation of Sensory Nerves
135(3)
Gate Control Theory
135(1)
Descending Pain Control Theory (Central Biasing Theory)
136(1)
Opiate Pain Control Theory
136(2)
Placebo Effect of Electrical Stimulation
138(1)
Clinical Uses of Low-Voltage Continuous Monophasic Current
138(1)
Medical Galvanism
138(1)
Iontophoresis
139(1)
Treatment Precautions with Continuous Monophasic Currents
139(1)
Functional Electrical Stimulation (FES)
139(1)
Clinical Uses of FES
140(1)
Specialized Electrical Currents
140(7)
Low-Intensity Stimulators (LIS)
140(3)
Russian Currents (Medium-Frequency Current Generators)
143(2)
Interferential Currents
145(2)
Conclusion
147(18)
Summary
147(18)
Iontophoresis
165(17)
William E. Prentice
Iontophoresis Versus Phonophoresis
165(1)
Basic Mechanisms of Ion Transfer
166(2)
Pharmacokinetics of Iontophoresis
166(1)
Movement of Ions in Solution
166(1)
Movement of Ions Through Tissue
166(2)
Iontophoresis Equipment and Treatment Techniques
168(4)
Type of Current Required
168(1)
Iontophoresis Generators
169(1)
Current Intensity
169(1)
Treatment Duration
170(1)
Dosage of Medication
170(1)
Electrodes
170(1)
Selecting the Appropriate Ion
171(1)
Clinical Applications for Iontophoresis
172(2)
Treatment Precautions and Contraindications
174(8)
Treatment of Burns
175(1)
Sensitivity Reactions to Ions
175(1)
Summary
175(7)
Biofeedback
182(19)
William E. Prentice
Electromyography and Biofeedback
182(1)
The Role of Biofeedback
183(1)
Biofeedback Instrumentation
183(2)
Peripheral Skin Temperature
183(1)
Finger Phototransmission
184(1)
Skin Conductance Activity
185(1)
Electromyographic Biofeedback
185(4)
Motor Unit Recruitment
185(1)
Measuring Electrical Activity
186(2)
Converting Electromyographic Activity to Meaningful Information
188(1)
Biofeedback Equipment and Treatment Techniques
189(3)
Electrodes
189(2)
Displaying the Information
191(1)
Clinical Applications for Biofeedback
192(9)
Muscle Reeducation
192(1)
Relaxation of Muscle Guarding
193(1)
Pain Reduction
193(1)
Summary
194(7)
Principles of Electrophysiologic Evaluation and Testing
201(58)
John Halle
David Greathouse
Introduction
202(1)
Electrophysiologic Testing Equipment and Setup
203(8)
Evaluation of the Peripheral Nervous System
211(2)
Anatomy of the Spinal Nerve and Neuromuscular Junction
213(2)
The Elements of the Spinal Nerve
215(1)
Testing Procedures
215(16)
Limb Temperature and Age Considerations
216(1)
Nerve Conduction Study
216(15)
The Electromyographic Examination
231(13)
Somatosensory Evoked Potentials
242(1)
Other Electrophysiologic Testing Procedures
243(1)
Requesting NCS/EMG Examinations
244(1)
Conclusion
244(15)
Summary
245(14)
Part Three Thermal Modalities
Shortwave and Microwave Diathermy
259(31)
William E. Prentice
David O. Draper
Physiologic Responses to Diathermy
260(1)
Thermal Effects
260(1)
Nonthermal Effects
261(1)
Shortwave Diathermy Equipment and Treatment Techniques
261(11)
Shortwave Diathermy Generators
261(2)
Shortwave Diathermy Electrodes
263(6)
Pulsed Shortwave Diathermy
269(2)
Treatment Time
271(1)
Microwave Diathermy
272(3)
Microwave Diathermy Generators
273(1)
Microwave Diathermy Applicators
273(1)
Microwave Treatment Technique
274(1)
Clinical Applications for Diathermy
275(1)
Diathermy Treatment Precautions and Considerations
276(2)
Comparing Shortwave Diathermy and Ultrasound as Thermal Modalities
278(2)
Guidelines for the Safe Use of Diathermy
280(10)
Summary
280(10)
Infrared Modalities
290(70)
Gerald W. Bell
William E. Prentice
Mechanisms of Heat Transfer
290(1)
Appropriate Use of the Infrared Modalities
291(1)
Clinical Use of the Infrared Modalities
292(3)
Effects of Tissue Temperature Change on Circulation
292(1)
Effects of Tissue Temperature Change on Muscle Spasm
293(1)
Effects of Temperature Change on Performance
294(1)
Cryotherapy
295(18)
Physiologic Effects of Tissue Cooling
295(2)
Cryotherapy Treatment Techniques
297(16)
Thermotherapy
313(12)
Physiologic Effects of Tissue Heating
313(1)
Thermotherapy Treatment Techniques
314(11)
Counterirritants
325(1)
Conclusions
325(35)
Summary
326(34)
Therapeutic Ultrasound
360(49)
David O. Draper
William E. Prentice
Ultrasound as a Thermal Modality
361(1)
Transmission of Acoustic Energy in Biologic Tissues
361(2)
Transverse Versus Longitudinal Waves
361(1)
Frequency of Wave Transmission
361(1)
Velocity
362(1)
Attenuation
362(1)
Basic Physics of Therapeutic Ultrasound
363(11)
Transducer
365(2)
Frequency of Therapeutic Ultrasound
367(2)
The Ultrasound Beam
369(2)
Pulsed Versus Continuous Wave Ultrasound
371(1)
Amplitude, Power, and Intensity
372(2)
Physiologic Effects of Ultrasound
374(2)
Thermal Effects
374(1)
Nonthermal Effects
375(1)
Ultrasound Treatment Techniques
376(7)
Frequency of Treatment
377(1)
Duration of Treatment
377(1)
Coupling Methods
378(1)
Exposure Techniques
379(2)
Moving the Transducer
381(2)
Recording Ultrasound Treatments
383(1)
Clinical Applications for Therapeutic Ultrasound
383(6)
Soft-Tissue Healing and Repair
383(2)
Scar Tissue and Joint Contracture
385(1)
Stretching of Connective Tissue
385(2)
Chronic Inflammation
387(1)
Bone Healing
387(1)
Pain Reduction
388(1)
Plantar Warts
388(1)
Placebo Effects
388(1)
Phonophoresis
389(2)
Using Ultrasound in Combination with Other Modalities
391(2)
Ultrasound and Hot Packs
391(1)
Ultrasound and Cold Packs
391(1)
Ultrasound and Electrical Stimulation
392(1)
Treatment Precautions
393(1)
Guidelines for the Safe Use of Ultrasound Equipment
393(16)
Summary
394(15)
Part Four Light Therapy
Low-Level Laser Therapy
409(24)
Ethan Saliba
Susan Foreman-Saliba
Physics
410(2)
Stimulated Emissions
410(2)
Types of Lasers
412(1)
Laser Generators
413(2)
Helium Neon Lasers
413(1)
Gallium Arsenide Lasers
414(1)
Laser Treatment Techniques
415(4)
Lasing Techniques
416(1)
Dosage
417(2)
Depth of Penetration
419(1)
Clinical Applications for Lasers
419(4)
Wound Healing
420(2)
Pain
422(1)
Bone Response
423(1)
Suggested Treatment Protocols
423(2)
Pain
424(1)
Wound Healing
424(1)
Scar Tissue
425(1)
Edema and Inflammation
425(1)
Safety
425(1)
Precautions and Contraindications
426(1)
Conclusion
426(7)
Summary
426(7)
Ultraviolet Therapy
433(20)
J. Marc Davis
Ultraviolet Radiation
433(1)
Effect on Cells
434(1)
Effect on Normal Human Tissue
434(3)
Short-Term Effect on Skin
434(2)
Tanning
436(1)
Long-Term Effect on Skin
437(1)
Effect on Eyes
437(1)
Systemic Effects
438(1)
Ultraviolet Generators
438(2)
Ultraviolet Treatment Techniques
440(2)
Determining the Minimal Erythemal Dose
440(1)
Positioning the Lamp
441(1)
Clinical Applications for Ultraviolet
442(2)
Psoriasis
442(1)
Disturbances of Calcium and Phosphorus Absorption
443(1)
Pressure Sores
444(1)
Sterilization
444(1)
Diagnosis
444(1)
Conclusion
444(9)
Summary
444(9)
Part Five Mechanical Modalities
Spinal Traction
453(31)
Daniel N. Hooker
The Physical Effects of Traction
453(5)
Effects on Spinal Movement
453(1)
Effects on Bone
454(1)
Effects on Ligaments
454(1)
Effects on the Disk
455(1)
Effects on Articular Facet Joints
456(1)
Effects on the Muscular System
456(1)
Effects on the Nerves
456(1)
Effects on the Entire Body Part
457(1)
Traction Treatment Techniques
458(1)
Lumbar Positional Traction
458(3)
Inversion Traction
461(1)
Manual Lumbar Traction
462(3)
Level-Specific Manual Traction
462(1)
Unilateral Leg Pull Manual Traction
463(2)
Mechanical Lumbar Traction
465(10)
Patient Setup and Equipment
465(3)
Body Position
468(3)
Traction Force
471(1)
Intermittent Versus Sustained Traction
472(1)
Duration of Treatment
473(1)
Progressive and Regressive Steps
473(2)
Manual Cervical Traction
475(1)
Mechanical Cervical Traction
476(2)
Indications and Contraindications
478(6)
Summary
479(5)
Intermittent Compression Devices
484(19)
Daniel N. Hooker
The Lymphatic System
485(1)
Purposes of the Lymphatic System
485(1)
Structure of the Lymphatic System
485(1)
Peripheral Lymphatic Structure and Function
485(1)
Injury Edema
486(3)
Formation of Pitting Edema
487(1)
Formation of Lymphedema
487(2)
The Negative Effects of Edema Accumulation
489(1)
Treatment of Edema
489(1)
Intermittent Compression Treatment Techniques
490(4)
Inflation Pressures
491(1)
On-Off Sequence
491(1)
Total Treatment Time
491(1)
Patient Setup and Instructions
492(2)
Cold and Compression Combination
494(1)
Sequential Compression Pumps
494(2)
Indications and Contraindications for Use
496(7)
Summary
496(7)
Part Six Other Modalities
Therapeutic Massage
503(34)
William E. Prentice
Clairbeth Lehn
The Value of Manual Therapy Techniques
503(1)
The Evolution of Massage as a Treatment Modality
503(1)
Physiologic Effects of Massage
504(3)
Reflexive Effects
504(1)
Mechanical Effects
505(2)
Psychologic Effects of Massage
507(1)
Massage Treatment Considerations and Guidelines
507(5)
Equipment
509(1)
Preparation of the Patient
510(2)
Massage Treatment Techniques
512(17)
Hoffa Massage
512(6)
Friction Massage
518(1)
Connective Tissue Massage
518(2)
Acupressure and Trigger Point Massage
520(4)
Myofascial Release
524(1)
Strain/Counterstrain
525(1)
Positional Release Therapy
526(1)
Active Release Technique
526(2)
Rolfing
528(1)
Trager
528(1)
The Current Role of Massage in Physical Therapy
529(8)
Summary
529(8)
Extracorporeal Shock Wave Therapy
537(14)
Charles Thigpen
History of ESWT
537(1)
Physical Characteristics of Extracorporeal Shock Wave
538(2)
Shock Wave Generation
540(1)
Physical Parameters of Shock Waves
540(1)
Biologic Effects
541(2)
Bone
542(1)
Tendon
542(1)
Clinical Applications
543(2)
Plantar Fasciitis
543(1)
Medial/Lateral Epicondylitis
544(1)
Calcific Tendinitis of the Shoulder
544(1)
Evaluation of ESWT Literature for Evidence-Based Practice
545(6)
Summary
545(6)
Part Seven Summary
The Physiologic Effects of Therapeutic Modality Intervention on the Body Systems
551(19)
Eric Shamus
Stanley H. Wilson
Systems Approach
552(1)
Electrical Stimulating Currents
552(3)
Interferential Current (IFC)
552(1)
Neuromuscular Electrical Stimulation (NMES)
553(1)
Transcutaneous Electrical Nerve Stimulation (TENS)
554(1)
Iontophoresis
555(1)
Biofeedback
556(1)
Cryotherapy Techniques
557(1)
Thermotherapy Techniques
558(3)
Warm Whirlpool Hot Packs
558(2)
Paraffin
560(1)
Infrared Lamps
560(1)
Fluidotherapy
561(1)
Therapeutic Ultrasound (US)
561(1)
Ultraviolet Therapy (UV)
562(1)
Traction (Manual and Mechanical)
563(1)
Compression Devices
564(1)
Massage
565(5)
Appendix A-1. Locations of the Motor Points570(3)
Appendix A-2. Units of Measure573(2)
Index575
William E. Prentice, PhD PT ATC, is Professor and Coordinator of the Sports Medicine Program; Clinical Professor, Division of Physical Therapy, Department of Medical Allied Professions; Associate Professor, Department of Orthopaedics, School of Medicine. He is at the University of North Carolina, Chapel Hill, North Carolina

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