Rehabilitation_Modalities R

ModalityIndication or diagnosis (contraindication!)ModalityLocation:? ?IntensityDuration:20~3010?Frequency

(94-2-75)

Temperature has an effect on:ViscosityNerve signal conduction: heat increases nerve conduction velocity; cold decreases it.Blood flow:heat increases arterial and capillary blood flow; cold decreases blood flow.Collagen extensibility: heat increases tendon extensibility; collagenase activity is increased; cold decreases enzyme activity.

heat therapy(97-1-70)

Therapeutic uses for heat are based on: Hyperemia Analgesia Hyperthermia Decreased muscle tone Increase in collagen elasticity

Applications for heat therapy: Generally used for chronic processes Reduction of muscle spasms Pain reduction (myofascial, low back, neck, postherpetic neuralgia) Reduction in joint stiffness, contractures Arthritis, collagen vascular diseases Chronic inflammation Superficial thrombophlebitis

(Hot packs) (Paraffin baths)Fluidotherapy (Infrared radiation)

(Hot packs)74.530

(Paraffin baths)Paraffin waxmineral oil 617152.2-54.4paraffin mixture

Fluidotherapy46.1-48.9

770nm1mm (800-1,500 nanometer) (1,500-150,000 nanometer)

1000nm30-60cm

1-3cm

:,

diathermy(101-2-71)

(Diathermy)

( )

(1) (Ultrasound Diathermy, USD)(2) (Shortwave diathermy, SWD)(3) (Microwave)

Therapeutic USUS(Thermal effect) (Non-thermal effect)

(hip)

(cavitation)( acousticstreaming ) (microstreaming)

(fibroblast)(growthfactor)

! ()

30 3 (100-1-70)

hot packinginfraredinterferential currentshortwave

shortwave(98-1-71)

(103-1-57)

cryotherapy(100-1-72)

()1)2)3)4)5)

))

T E N S( Transcutaneous Electrical Nerve Stimulation )I FC ( Interferentialcurrent therapy ) E S ( Electrical Stimulation )FES (Functional Electrical Stimulation)

(

TENSdorsal rootsubstantia gelatinosainterneurons

endorphins

100Hz

Cardiac pacemakerTENS: near the carotid sinus and pregnant women is avoided. Psychogenic pain is particularly resistant to TENS

IFC

1kHz10kHz

0 ~ 100 Hz4000Hz4001 Hz4100 Hz

0 ~ 100 Hz

05Hz

3050Hz

50Hz

IFCimplanted stimulatorssympathetic gangliacarotid sinusgravid uterus venous thrombosisSWDexcessive electrical astimulation

(95-1-95)

Hot packingPelvic tractionInterferential currentShortwave

Electrical Stimulation (ES)

(FES)

1000HZ 100HZ 100HZ

:

90mW14 J10-100W()

intense, focal light therapyphysiologic effectnon-thermal effect

collagen production, DNA

:

,

Skin ulcersPsoriasisUltraviolet A320-400nmdeeply but least biologic activityUltraviolet B290-320nm + skin erythemaUltraviolet C200-290nm + skin erythema

nonmelanoma skin cancercataracts

: 1.,2.porphyrias.3.4..5..6.,,,.

:,

:1.,2.,33-34;,26

MRI(102-1-59)pelvic tractionelectric stimulationultrasoundhydrotherapy

Traction Physiologic EffectsVertebral joint distractionelongation of the cervical spine of 220 mm, can be achieved with 25 pounds or more of tractive forceReduction of compression and nerve root and disc irritationReduction of pain, muscle spasm, and inflammationLoosening of adhesions in the dural sleeves

General ContraindicationsMalignancy in the region of the spine Osteopenia Infectious process Congenital spinal deformity Increased pain

Contraindications to Cervical Spine TractionCervical ligamentous instabilityRA, Downs syndrome, Marfan syndrome, achondroplasticdwarfism, EhlersDanlos syndromeInfectious process of the spineAtlantoaxial subluxation with spinal cord compromiseVertebrobasilar insufficiency

Contraindications to Lumbar Spine Traction Pregnancy Cauda equina compression Aortic aneurysms Restrictive lung disease Active peptic ulcer disease Hiatal hernia

Cervical spine

Lumbar spine

;