Additional Information
Book Details
Abstract
With straightforward, in-depth coverage of the use of physical agents to improve patient outcomes, Physical Agents in Rehabilitation: An Evidence-Based Approach to Practice, 5th Edition reflects how physical agents and modalities are being discussed in the classroom. This new edition brings the ideal balance of evidence and practical instruction to the learning and practice of physical agents in rehabilitation. Comprehensive coverage of all physical agents includes the mechanisms, clinical effects, and application techniques for thermal agents, ultrasound, electrical currents, electromagnetic radiation, hydrotherapy, traction, and compression. Plus, each chapter includes a scientific rationale and step-by-step instructions in the use of the agent(s), as well as up-to-date research support and new Find the Evidence tables. The new edition is supported with electronic ancillaries including review questions for students, PowerPoints®, and links to all references on Medline.
- Comprehensive coverage of all physical agents includes the mechanisms, clinical effects, and application techniques for thermal agents, ultrasound, electrical currents, electromagnetic radiation, hydrotherapy, traction, and compression.
- Find the Evidence tables guide the reader in finding up-to-date, patient-specific evidence using the PICO framework.
- UNIQUE Step-by-step illustrated application techniques boxes guide you in reproducing effective treatment options.
- Electronic ancillaries
- Electrical Stimulation, Ultrasound & Laser Light Handbook helps you to understand the material and can be printed out for quick reference to use in the clinical setting.
- NEW! Chapter on biofeedback complements the coverage of powered devices used in rehabilitation.
- UNIQUE! New Find the Evidence tables guide the reader in finding up-to-date, patient-specific evidence using the PICO framework.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| IFC_Evolve page | ifc1 | ||
| Physical Agents in Rehabilitation | i | ||
| Copyright Page | iv | ||
| Biography | v | ||
| Acknowledgments | vi | ||
| Contributors | vii | ||
| Preface | viii | ||
| Table Of Contents | ix | ||
| I Introduction to Physical Agents | 1 | ||
| 1 The Physiology of Physical Agents | 1 | ||
| Chapter Outline | 1 | ||
| How to Use This Book | 1 | ||
| What Are Physical Agents? | 2 | ||
| Categories of Physical Agents | 2 | ||
| Thermal Agents | 2 | ||
| Mechanical Agents | 2 | ||
| Electromagnetic Agents | 3 | ||
| Effects of Physical Agents | 3 | ||
| Inflammation and Healing | 3 | ||
| Physical Agents for Tissue Healing | 4 | ||
| Initial Injury. | 4 | ||
| Acute Inflammation. | 4 | ||
| Chronic Inflammation. | 5 | ||
| Proliferation. | 5 | ||
| Maturation. | 5 | ||
| Pain | 5 | ||
| Physical Agents for Pain Modulation | 6 | ||
| Acute Pain. | 6 | ||
| Chronic Pain. | 6 | ||
| Referred Pain. | 6 | ||
| Pain Caused by Malignancy. | 6 | ||
| Complex Regional Pain Syndrome. | 7 | ||
| Collagen Extensibility and Motion Restrictions | 7 | ||
| Physical Agents for the Treatment of Motion Restrictions | 7 | ||
| Muscle Tone | 8 | ||
| Physical Agents for Tone Abnormalities | 8 | ||
| General Contraindications and Precautions for Physical Agent Use | 9 | ||
| Pregnancy | 9 | ||
| Malignancy | 9 | ||
| Pacemaker or Other Implanted Electronic Device | 9 | ||
| Impaired Sensation and Mentation | 9 | ||
| Evaluation and Planning for the Use of Physical Agents | 10 | ||
| Choosing a Physical Agent | 10 | ||
| Attributes to Consider in the Selection of Physical Agents | 10 | ||
| Using Physical Agents in Combination With Each Other or With Other Interventions | 11 | ||
| Documentation | 12 | ||
| Chapter Review | 12 | ||
| Glossary | 12 | ||
| References | 13 | ||
| 2 Physical Agents in Clinical Practice | 15 | ||
| Chapter Outline | 15 | ||
| History of Physical Agents in Medicine and Rehabilitation | 15 | ||
| Approaches to Rehabilitation | 16 | ||
| The Role of Physical Agents in Rehabilitation | 17 | ||
| Practitioners Using Physical Agents | 18 | ||
| Evidence-Based Practice | 18 | ||
| Using Physical Agents Within Different Health Care Delivery Systems | 21 | ||
| Chapter Review | 22 | ||
| Glossary | 22 | ||
| References | 23 | ||
| II Pathology and Patient Problems | 25 | ||
| 3 Inflammation and Tissue Repair | 25 | ||
| Chapter Outline | 25 | ||
| Phases of Inflammation and Healing | 25 | ||
| Inflammation Phase (Days 1 to 6) | 25 | ||
| Vascular Response | 26 | ||
| Hemostatic Response | 31 | ||
| Cellular Response | 31 | ||
| Immune Response | 32 | ||
| Proliferation Phase (Days 3 to 20) | 33 | ||
| Epithelialization | 34 | ||
| Collagen Production | 34 | ||
| Wound Contraction | 35 | ||
| Neovascularization | 36 | ||
| Maturation Phase (Day 9 Forward) | 36 | ||
| Chronic Inflammation | 38 | ||
| Factors Affecting the Healing Process | 38 | ||
| Local Factors | 40 | ||
| Type, Size, and Location of the Injury | 40 | ||
| Infection | 40 | ||
| Vascular Supply | 40 | ||
| External Forces | 40 | ||
| Movement | 40 | ||
| Systemic Factors | 40 | ||
| Age | 40 | ||
| Disease | 40 | ||
| Medications | 41 | ||
| Nutrition | 41 | ||
| Adjuncts to Promote Wound Healing | 41 | ||
| Healing of Specific Musculoskeletal Tissues | 41 | ||
| Cartilage | 41 | ||
| Tendons and Ligaments | 42 | ||
| Skeletal Muscle | 42 | ||
| Bone | 42 | ||
| Chapter Review | 44 | ||
| Glossary | 45 | ||
| References | 46 | ||
| 4 Pain and Pain Management | 49 | ||
| Chapter Outline | 49 | ||
| Pain, Nociception, and the Nociceptive System | 50 | ||
| Nociceptors | 50 | ||
| Primary Afferent Neurons | 50 | ||
| Central Pathways | 51 | ||
| The Endogenous Opioid System | 52 | ||
| Central Sensitization | 52 | ||
| Modulation of Nociception in the Brain | 53 | ||
| Homeostatic Systems | 54 | ||
| Types of Pain | 54 | ||
| Acute Pain | 54 | ||
| Preventing Acute Pain From Becoming Chronic | 55 | ||
| Chronic Pain | 56 | ||
| Primary Chronic Nociceptive Pain | 56 | ||
| Peripheral Neuropathic Pain | 57 | ||
| Central Sensitization | 57 | ||
| Psychosocial Pain | 58 | ||
| Measuring Pain | 58 | ||
| Visual Analog and Numerical Scales | 58 | ||
| Semantic Differential Scales | 60 | ||
| Other Measures | 61 | ||
| Pain Management | 61 | ||
| Physical Agents | 62 | ||
| Pharmacological Approaches | 62 | ||
| Systemic Analgesics | 63 | ||
| Nonsteroidal Antiinflammatory Drugs. | 63 | ||
| Acetaminophen. | 63 | ||
| Opioids. | 63 | ||
| Antidepressants. | 64 | ||
| Anticonvulsants. | 64 | ||
| Spinal Analgesia | 64 | ||
| Local Injection | 65 | ||
| Topical Analgesics | 65 | ||
| Cognitive-Behavioral Therapy | 65 | ||
| Pacing | 65 | ||
| Cognitive Restructuring | 65 | ||
| Graded Exposure | 65 | ||
| Comprehensive Pain Management Programs | 65 | ||
| Chapter Review | 68 | ||
| Glossary | 68 | ||
| References | 69 | ||
| 5 Tone Abnormalities | 73 | ||
| Chapter Outline | 73 | ||
| Muscle Tone | 73 | ||
| Challenges to Assessing Muscle Tone | 73 | ||
| Tone Abnormalities | 74 | ||
| Hypotonicity | 74 | ||
| Hypertonicity | 74 | ||
| Terms Confused With Muscle Tone | 75 | ||
| Fluctuating Abnormal Tone | 75 | ||
| Measuring Muscle Tone | 75 | ||
| Quantitative Measures | 76 | ||
| Dynamometer or Myometer | 76 | ||
| Isokinetic Testing Systems | 76 | ||
| Electromyography | 76 | ||
| Pendulum Test | 77 | ||
| Qualitative Measures | 77 | ||
| Clinical Tone Scale | 77 | ||
| Muscle Stretch Reflex Test | 78 | ||
| Ashworth and Modified Ashworth Scales | 78 | ||
| Other Scales Used to Measure Tone | 78 | ||
| General Considerations When Muscle Tone Is Measured | 78 | ||
| Anatomical Bases of Muscle Tone and Activation | 79 | ||
| Muscular Contributions to Muscle Tone and Activation | 80 | ||
| Neural Contributions to Muscle Tone and Activation | 81 | ||
| Structure and Function of Nerves | 81 | ||
| Sources of Neural Stimulation of Muscle | 84 | ||
| Alpha Motor Neuron | 84 | ||
| Input From the Periphery | 84 | ||
| Muscle Spindle. | 86 | ||
| Golgi Tendon Organs. | 87 | ||
| Cutaneous Receptors. | 88 | ||
| Input From Spinal Sources | 88 | ||
| Input From Supraspinal Sources | 89 | ||
| Sensorimotor Cortical Contributions. | 89 | ||
| Cerebellum. | 89 | ||
| Basal Ganglia. | 89 | ||
| Other Descending Input. | 90 | ||
| Limbic System. | 91 | ||
| Summary of Normal Muscle Tone | 91 | ||
| Abnormal Muscle Tone and Its Consequences | 91 | ||
| Low Muscle Tone | 92 | ||
| Alpha Motor Neuron Damage | 92 | ||
| Rehabilitation After Alpha Motor Neuron Damage. | 93 | ||
| Insufficient Excitation of Alpha Motor Neurons | 93 | ||
| Altered Peripheral Input: Immobilization. | 93 | ||
| Altered Supraspinal Input: Stroke, Multiple Sclerosis, or Head Injury. | 94 | ||
| Rehabilitation to Increase Muscle Tone. | 94 | ||
| High Muscle Tone | 94 | ||
| Noxious Stimuli, Cold, and Stress | 95 | ||
| Managing Hypertonicity as a Result of Noxious Stimuli, Cold, or Stress. | 95 | ||
| Spinal Cord Injury | 95 | ||
| Managing Hypertonicity After Spinal Cord Injury. | 95 | ||
| Cerebral Lesions | 96 | ||
| Hypertonicity: Primary Impairment or Adaptive Response? | 96 | ||
| Managing Hypertonicity After Stroke. | 96 | ||
| Rigidity: A Consequence of Central Nervous System Pathology. | 97 | ||
| Fluctuating Muscle Tone | 97 | ||
| Chapter Review | 101 | ||
| Glossary | 101 | ||
| References | 102 | ||
| 6 Motion Restrictions | 105 | ||
| Chapter Outline | 105 | ||
| Types of Motion | 106 | ||
| Active Motion | 106 | ||
| Passive Motion | 106 | ||
| Physiological and Accessory Motion | 106 | ||
| Patterns of Motion Restriction | 108 | ||
| Capsular Pattern of Motion Restriction | 108 | ||
| Noncapsular Pattern of Motion Restriction | 108 | ||
| Tissues That Can Restrict Motion | 108 | ||
| Contractile Tissues | 108 | ||
| Noncontractile Tissues | 109 | ||
| Pathologies That Can Cause Motion Restriction | 109 | ||
| Contracture | 109 | ||
| Edema | 109 | ||
| Adhesion | 110 | ||
| Mechanical Block | 110 | ||
| Spinal Disc Herniation | 110 | ||
| Adverse Neural Tension | 111 | ||
| Weakness | 111 | ||
| Other Factors | 111 | ||
| Examination and Evaluation of Motion Restrictions | 111 | ||
| Quantitative Measures | 111 | ||
| Qualitative Measures | 112 | ||
| Test Methods and Rationale | 112 | ||
| Active Range of Motion | 112 | ||
| Resisted Muscle Testing | 112 | ||
| Passive Range of Motion | 112 | ||
| Combining the Findings of Active Range-of-Motion, Resisted Muscle Contraction, and Passive Range-of-Motion Testing. | 112 | ||
| Passive Accessory Motion | 112 | ||
| Muscle Length | 113 | ||
| Adverse Neural Tension | 114 | ||
| Contraindications and Precautions to Range-of-Motion Techniques | 114 | ||
| Treatment Approaches for Motion Restrictions | 114 | ||
| Stretching | 114 | ||
| Motion | 116 | ||
| Surgery | 116 | ||
| Role of Physical Agents in the Treatment of Motion Restrictions | 116 | ||
| Increase Soft Tissue Extensibility | 116 | ||
| Control Inflammation and Adhesion Formation | 117 | ||
| Control Pain During Stretching | 117 | ||
| Facilitate Motion | 117 | ||
| Chapter Review | 120 | ||
| Glossary | 120 | ||
| References | 120 | ||
| III Thermal Agents | 123 | ||
| 7 Introduction to Thermal Agents | 123 | ||
| Chapter Outline | 123 | ||
| Specific Heat | 123 | ||
| Modes of Heat Transfer | 123 | ||
| Conduction | 123 | ||
| Rate of Heat Transfer by Conduction | 124 | ||
| Guidelines for Heat Transfer by Conduction | 124 | ||
| Convection | 125 | ||
| Conversion | 125 | ||
| Radiation | 125 | ||
| Evaporation | 126 | ||
| Chapter Review | 126 | ||
| Glossary | 126 | ||
| 8 Superficial Cold and Heat | 127 | ||
| Chapter Outline | 127 | ||
| Cryotherapy | 127 | ||
| Effects of Cold | 127 | ||
| Hemodynamic Effects | 127 | ||
| Initial Decrease in Blood Flow | 127 | ||
| Later Increase in Blood Flow | 128 | ||
| Neuromuscular Effects | 129 | ||
| Decreased Nerve Conduction Velocity | 129 | ||
| Reduced Pain and Increased Pain Threshold | 129 | ||
| Altered Muscle Strength | 129 | ||
| Decreased Spasticity | 130 | ||
| Facilitation of Muscle Contraction | 130 | ||
| Metabolic Effects | 130 | ||
| Decreased Metabolic Rate | 130 | ||
| Clinical Indications for Cryotherapy | 130 | ||
| Inflammation Control | 130 | ||
| Edema Control | 131 | ||
| Pain Control | 132 | ||
| Modification of Spasticity | 132 | ||
| Symptom Management in Multiple Sclerosis | 132 | ||
| Facilitation | 132 | ||
| Cryokinetics and Cryostretch | 132 | ||
| Contraindications and Precautions for Cryotherapy | 133 | ||
| Contraindications for the Use of Cryotherapy | 133 | ||
| Cold Hypersensitivity (Cold-Induced Urticaria) | 133 | ||
| Cold Intolerance | 133 | ||
| Cryoglobulinemia | 133 | ||
| Paroxysmal Cold Hemoglobinuria | 133 | ||
| Raynaud Disease and Phenomenon | 133 | ||
| Overregenerating Peripheral Nerves | 133 | ||
| Over an Area With Circulatory Compromise or Peripheral Vascular Disease | 134 | ||
| Precautions for the Use of Cryotherapy | 134 | ||
| Over the Superficial Main Branch of a Nerve | 134 | ||
| Over an Open Wound | 134 | ||
| Hypertension | 134 | ||
| Poor Sensation or Mentation | 134 | ||
| Very Young and Very Old Patients | 134 | ||
| Adverse Effects of Cryotherapy | 134 | ||
| Application Techniques | 135 | ||
| General Cryotherapy | 135 | ||
| Cold Packs or Ice Packs | 135 | ||
| Ice Massage | 137 | ||
| Controlled Cold Compression Unit | 138 | ||
| Vapocoolant Sprays and Brief Icing | 140 | ||
| Documentation | 141 | ||
| Examples | 141 | ||
| Thermotherapy | 146 | ||
| Effects of Heat | 146 | ||
| Hemodynamic Effects | 146 | ||
| Vasodilation | 146 | ||
| Neuromuscular Effects | 147 | ||
| Changes in Nerve Conduction Velocity and Firing Rate | 147 | ||
| Increased Pain Threshold | 147 | ||
| Changes in Muscle Strength | 147 | ||
| Metabolic Effects | 147 | ||
| Increased Metabolic Rate | 147 | ||
| Altered Tissue Extensibility | 148 | ||
| Increased Collagen Extensibility | 148 | ||
| Clinical Indications for Superficial Heat | 148 | ||
| Pain Control | 148 | ||
| Increased Range of Motion and Decreased Joint Stiffness | 148 | ||
| Accelerated Healing | 149 | ||
| Infrared Radiation for Psoriasis | 149 | ||
| Contraindications and Precautions for Thermotherapy | 149 | ||
| Contraindications for the Use of Thermotherapy | 149 | ||
| Recent or Potential Hemorrhage | 150 | ||
| Thrombophlebitis | 150 | ||
| Impaired Sensation or Impaired Mentation | 150 | ||
| Malignant Tissue | 150 | ||
| Infrared Irradiation of the Eyes | 150 | ||
| Precautions for the Use of Thermotherapy | 150 | ||
| Acute Injury or Inflammation | 151 | ||
| Pregnancy | 151 | ||
| Impaired Circulation or Poor Thermal Regulation | 151 | ||
| Edema | 151 | ||
| Cardiac Insufficiency | 151 | ||
| Metal in the Area | 151 | ||
| Over an Open Wound | 152 | ||
| Over Areas Where Topical Counterirritants Have Recently Been Applied | 152 | ||
| Demyelinated Nerves | 152 | ||
| Adverse Effects of Thermotherapy | 152 | ||
| Burns | 152 | ||
| Fainting | 153 | ||
| Bleeding | 153 | ||
| Skin and Eye Damage From Infrared Radiation | 153 | ||
| Application Techniques | 153 | ||
| General Thermotherapy | 153 | ||
| Hot Packs | 154 | ||
| Paraffin | 156 | ||
| Fluidotherapy | 158 | ||
| Infrared Lamps | 159 | ||
| Contrast Bath | 161 | ||
| Documentation | 162 | ||
| Examples | 162 | ||
| Choosing Between Cryotherapy and Thermotherapy | 168 | ||
| Chapter Review | 168 | ||
| Glossary | 168 | ||
| References | 169 | ||
| 9 Ultrasound | 172 | ||
| Chapter Outline | 172 | ||
| Introduction | 172 | ||
| Terminology | 172 | ||
| History | 172 | ||
| Ultrasound Definition | 173 | ||
| Generation of Ultrasound | 173 | ||
| Effects of Ultrasound | 174 | ||
| Thermal Effects | 174 | ||
| Tissues Affected | 174 | ||
| Factors Affecting the Amount of Temperature Increase | 174 | ||
| Applying Other Physical Agents in Conjunction With Ultrasound | 175 | ||
| Nonthermal Effects | 176 | ||
| Clinical Indications for Ultrasound | 176 | ||
| Soft Tissue Shortening | 176 | ||
| Pain Control | 177 | ||
| Soft Tissue Healing | 177 | ||
| Tendon and Ligament Injuries | 178 | ||
| Bone Fractures | 179 | ||
| Carpal Tunnel Syndrome | 180 | ||
| Phonophoresis | 180 | ||
| Contraindications and Precautions for Ultrasound | 181 | ||
| Contraindications for Ultrasound | 182 | ||
| Malignant Tumor | 182 | ||
| Pregnancy | 182 | ||
| Central Nervous System Tissue | 182 | ||
| Methyl Methacrylate Cement or Plastic | 182 | ||
| Pacemaker or Implantable Cardiac Rhythm Device | 183 | ||
| Thrombophlebitis | 183 | ||
| Eyes | 183 | ||
| Reproductive Organs | 183 | ||
| Precautions for Ultrasound | 183 | ||
| Acute Inflammation | 183 | ||
| Epiphyseal Plates | 183 | ||
| Fractures | 183 | ||
| Breast Implants | 183 | ||
| Adverse Effects of Ultrasound | 183 | ||
| Application Technique | 184 | ||
| Ultrasound Treatment Parameters | 184 | ||
| Frequency | 184 | ||
| Duty Cycle | 185 | ||
| Intensity | 185 | ||
| Duration | 185 | ||
| Area to Be Treated | 185 | ||
| Number and Frequency of Treatments | 185 | ||
| Sequence of Treatment | 186 | ||
| Moving the Sound Head | 186 | ||
| Documentation | 186 | ||
| Examples | 186 | ||
| Chapter Review | 192 | ||
| Glossary | 192 | ||
| General | 192 | ||
| Treatment Parameters | 194 | ||
| References | 196 | ||
| 10 Diathermy | 200 | ||
| Chapter Outline | 200 | ||
| Physical Properties of Diathermy | 201 | ||
| Types of Diathermy Applicators | 202 | ||
| Inductive Coil | 202 | ||
| Capacitive Plates | 203 | ||
| Magnetron (Condenser) | 203 | ||
| Effects of Diathermy | 203 | ||
| Thermal Effects | 203 | ||
| Nonthermal Effects | 203 | ||
| Altered Cell Membrane Function and Cellular Activity | 204 | ||
| Increased Microvascular Perfusion | 204 | ||
| Clinical Indications for Diathermy | 205 | ||
| Thermal-Level Diathermy | 205 | ||
| Nonthermal Shortwave Therapy | 206 | ||
| Control of Pain and Edema | 206 | ||
| Soft Tissue Healing | 206 | ||
| Nerve Healing | 206 | ||
| Bone Healing | 206 | ||
| Osteoarthritis Symptoms | 207 | ||
| Contraindications and Precautions for Diathermy | 207 | ||
| Contraindications for All Forms of Diathermy | 207 | ||
| Implanted or Transcutaneous Neural Stimulators, Including Cardiac Pacemakers | 207 | ||
| Pregnancy | 207 | ||
| Contraindications for Thermal-Level Diathermy | 207 | ||
| Metal Implants | 207 | ||
| Malignancy | 208 | ||
| Over the Eyes | 208 | ||
| Over the Testes | 208 | ||
| Over Growing Epiphyses | 208 | ||
| Contraindications for Nonthermal Shortwave Therapy | 208 | ||
| Deep Tissues Such as Internal Organs | 208 | ||
| Substitute for Conventional Therapy for Edema and Pain | 208 | ||
| Implanted Pacemakers, Electronic Devices, or Metal Implants | 208 | ||
| Precautions for All Forms of Diathermy | 208 | ||
| Near Electronic or Magnetic Equipment | 208 | ||
| Obesity | 209 | ||
| Copper-Bearing Intrauterine Contraceptive Devices | 209 | ||
| Precautions for Nonthermal Shortwave Therapy | 209 | ||
| Precautions for Therapists Applying Diathermy | 209 | ||
| Malignancy and Electromagnetic Fields | 209 | ||
| Adverse Effects of Diathermy | 209 | ||
| Burns | 209 | ||
| Application Technique | 209 | ||
| Positioning | 210 | ||
| Inductive Applicator | 210 | ||
| Capacitive Applicator | 211 | ||
| Magnetron Microwave Applicator | 211 | ||
| Documentation | 211 | ||
| Examples | 211 | ||
| Chapter Review | 216 | ||
| Glossary | 216 | ||
| References | 216 | ||
| IV Electrical Currents | 219 | ||
| 11 Introduction to Electrotherapy | 219 | ||
| Chapter Outline | 219 | ||
| Electrical Current Devices, Waveforms, and Parameters | 220 | ||
| Waveforms | 220 | ||
| Direct Current, Alternating Current, and Pulsed Current | 220 | ||
| Interferential Current, Premodulated Current, and Russian Protocol | 222 | ||
| Parameters | 222 | ||
| Effects of Electrical Currents | 225 | ||
| Stimulation of Action Potentials in Nerves | 225 | ||
| Strength-Duration Curve | 226 | ||
| Action Potential Propagation | 227 | ||
| Direct Muscle Depolarization | 228 | ||
| Ionic Effects of Electrical Currents | 228 | ||
| Contraindications and Precautions for Electrical Currents | 228 | ||
| Contraindications for Electrical Currents | 229 | ||
| Demand Pacemaker, Implantable Cardiac Defibrillator, or Unstable Arrhythmias | 229 | ||
| Over the Carotid Sinus | 229 | ||
| Venous or Arterial Thrombosis or Thrombophlebitis | 230 | ||
| Pelvis, Abdomen, Trunk, and Low Back Area During Pregnancy | 230 | ||
| Precautions for Electrical Currents | 230 | ||
| Cardiac Disease | 230 | ||
| Impaired Mentation or Impaired Sensation | 230 | ||
| Malignant Tumors | 230 | ||
| Skin Irritation or Open Wounds | 231 | ||
| Adverse Effects of Electrical Currents | 231 | ||
| Application Technique | 231 | ||
| Patient Positioning | 232 | ||
| Electrode Type | 232 | ||
| Electrode Placement | 233 | ||
| Documentation | 234 | ||
| Chapter Review | 234 | ||
| Glossary | 234 | ||
| References | 236 | ||
| 12 Electrical Currents for Muscle Contraction | 238 | ||
| Chapter Outline | 238 | ||
| Effects of Electrically Stimulated Muscle Contractions | 238 | ||
| Innervated Muscle | 238 | ||
| Denervated Muscle | 239 | ||
| Clinical Applications of Electrically Stimulated Muscle Contractions | 239 | ||
| Muscle Strengthening for Patients With Orthopedic Conditions | 239 | ||
| Neuromuscular Electrical Stimulation After Anterior Cruciate Ligament Reconstruction | 240 | ||
| Neuromuscular Electrical Stimulation After Total Knee Arthroplasty | 240 | ||
| Neuromuscular Electrical Stimulation for Other Orthopedic Conditions | 240 | ||
| Cardiorespiratory and Functional Training for Patients With Cardiac, Pulmonary, or Critical Illness | 241 | ||
| Muscle Strengthening for Healthy Adults and Athletes | 241 | ||
| Improved Muscle Coordination and Motor Control for Patients With Neurological Conditions | 241 | ||
| Neuromuscular Electrical Stimulation After Stroke | 241 | ||
| Neuromuscular Electrical Stimulation After Spinal Cord Injury | 242 | ||
| Neuromuscular Electrical Stimulation in Patients With Other Central Nervous System Disorders | 243 | ||
| Neuromuscular Electrical Stimulation for Dysphagia | 243 | ||
| Neuromuscular Electrical Stimulation for Urinary Incontinence | 243 | ||
| Edema Control and Improved Circulation | 244 | ||
| Retardation of Atrophy and Return of Function in Denervated Muscle | 244 | ||
| Contraindications and Precautions for Electrically Stimulated Muscle Contractions | 244 | ||
| Contraindications for Electrically Stimulated Muscle Contractions | 245 | ||
| When Contraction of the Muscle May Disrupt Healing (e.g., Muscle or Tendon Tear, Overuse Injury) | 245 | ||
| Precautions for Electrically Stimulated Muscle Contractions | 245 | ||
| Application Techniques | 245 | ||
| Documentation | 249 | ||
| Examples | 249 | ||
| Chapter Review | 253 | ||
| Glossary | 253 | ||
| References | 254 | ||
| 13 Electrical Currents for Pain Control | 258 | ||
| Chapter Outline | 258 | ||
| Mechanisms Underlying Electrical Current Use for Pain Control | 258 | ||
| Gate Control | 258 | ||
| Opioid Release | 258 | ||
| Selecting Transcutaneous Electrical Nerve Stimulation Approaches | 259 | ||
| Clinical Applications of Electrical Currents for Pain Control | 260 | ||
| Acute Pain | 261 | ||
| Chronic Pain | 261 | ||
| Contraindications and Precautions for Electrical Currents for Pain Control | 261 | ||
| Contraindications for Electrical Currents for Pain Control | 261 | ||
| Precautions for Electrical Currents for Pain Control | 262 | ||
| Adverse Effects of Transcutaneous Electrical Nerve Stimulation | 262 | ||
| Application Technique | 262 | ||
| Documentation | 264 | ||
| Examples | 264 | ||
| Chapter Review | 268 | ||
| Glossary | 268 | ||
| References | 269 | ||
| 14 Electrical Currents for Soft Tissue Healing | 271 | ||
| Chapter Outline | 271 | ||
| Mechanisms Underlying Electrical Currents for Tissue Healing | 271 | ||
| Galvanotaxis | 271 | ||
| Cell Activation | 272 | ||
| Antimicrobial Effects | 272 | ||
| Enhanced Circulation | 272 | ||
| Clinical Applications of Electrical Stimulation for Soft Tissue Healing | 272 | ||
| Chronic Wounds: Pressure Ulcers, Diabetic Ulcers, Venous Ulcers | 272 | ||
| Edema Control | 273 | ||
| Edema Due to Inflammation | 273 | ||
| Edema Due to Lack of Muscle Contraction | 274 | ||
| Transdermal Drug Delivery: Iontophoresis | 274 | ||
| Contraindications and Precautions for Electrical Currents for Tissue Healing | 275 | ||
| Contraindications for Electrical Currents for Tissue Healing | 276 | ||
| Malignant Tumors | 276 | ||
| Iontophoresis After Any Intervention That Is Likely to Alter Skin Permeability | 276 | ||
| Precautions for Electrical Currents for Tissue Healing | 276 | ||
| Adverse Effects of Electrical Currents for Tissue Healing | 276 | ||
| Application Techniques | 276 | ||
| Documentation | 281 | ||
| Examples | 281 | ||
| Chapter Review | 286 | ||
| Glossary | 286 | ||
| References | 286 | ||
| 15 Electromyographic (EMG) Biofeedback | 289 | ||
| Chapter Outline | 289 | ||
| Introduction | 289 | ||
| Terminology | 289 | ||
| History of Biofeedback | 289 | ||
| EMG Biofeedback Definition | 290 | ||
| Parameters | 290 | ||
| Physiological Effects of EMG Biofeedback | 292 | ||
| Neuromuscular Facilitation | 293 | ||
| Neuromuscular Inhibition | 294 | ||
| Neuromuscular Coordination | 294 | ||
| Clinical Indications for EMG Biofeedback | 294 | ||
| Hemiplegia | 294 | ||
| Quadriceps Strengthening | 295 | ||
| Headache | 295 | ||
| Pelvic Floor Disorders | 295 | ||
| Chronic Pain Conditions | 296 | ||
| Temporomandibular Disorders | 296 | ||
| Contraindications and Precautions for EMG Biofeedback | 296 | ||
| Contraindications and Precautions | 296 | ||
| Acute Inflammatory Conditions | 296 | ||
| Pregnancy | 297 | ||
| Bladder or Vaginal Infection | 297 | ||
| Adverse Effects of EMG Biofeedback | 297 | ||
| Application Technique | 297 | ||
| Parameters for EMG Biofeedback | 298 | ||
| Documentation | 298 | ||
| Examples | 298 | ||
| Chapter Review | 303 | ||
| Glossary | 303 | ||
| References | 303 | ||
| V Electromagnetic Agents | 305 | ||
| 16 Lasers and Light | 305 | ||
| Chapter Outline | 305 | ||
| Introduction | 305 | ||
| Terminology | 305 | ||
| Electromagnetic Radiation, Lasers, and Light | 305 | ||
| History of Electromagnetic Radiation | 305 | ||
| Physical Properties of Electromagnetic Radiation | 307 | ||
| Light Sources. | 309 | ||
| Wavelength. | 311 | ||
| Power and Power Density. | 311 | ||
| Energy and Energy Density. | 311 | ||
| Physiological Effects of Electromagnetic Radiation | 311 | ||
| Physiological Effects of Lasers and Light | 312 | ||
| Promote Adenosine Triphosphate Production | 312 | ||
| Promote Collagen Production | 312 | ||
| Modulate Inflammation | 312 | ||
| Inhibit Growth of Microorganisms | 312 | ||
| Promote Vasodilation | 313 | ||
| Alter Nerve Conduction Velocity and Regeneration | 313 | ||
| Clinical Indications for Lasers and Light | 313 | ||
| Soft Tissue and Bone Healing | 313 | ||
| Arthritis | 314 | ||
| Lymphedema | 314 | ||
| Neurological Conditions | 314 | ||
| Pain Management | 315 | ||
| Contraindications and Precautions for Lasers and Light | 315 | ||
| Contraindications for Lasers and Light | 315 | ||
| Direct Irradiation of the Eyes | 315 | ||
| Malignancy | 315 | ||
| Within 4 to 6 Months After Radiotherapy | 316 | ||
| Over Hemorrhaging Regions | 316 | ||
| Over the Thyroid or Other Endocrine Glands | 316 | ||
| Precautions for Lasers and Light | 316 | ||
| Low Back or Abdomen During Pregnancy | 316 | ||
| Epiphyseal Plates in Children | 316 | ||
| Impaired Sensation or Mentation | 316 | ||
| Photophobia or Pretreatment With Photosensitizers | 316 | ||
| Adverse Effects of Lasers and Light | 317 | ||
| Application Technique | 317 | ||
| Parameters for the Use of Lasers and Light | 318 | ||
| Type of Diode | 318 | ||
| Wavelength | 319 | ||
| Power | 319 | ||
| Energy Density | 319 | ||
| Documentation | 320 | ||
| Examples | 320 | ||
| Chapter Review | 323 | ||
| Glossary | 323 | ||
| References | 324 | ||
| 17 Ultraviolet Therapy | 327 | ||
| Chapter Outline | 327 | ||
| Physical Properties of Ultraviolet Radiation | 327 | ||
| Effects of Ultraviolet Radiation | 327 | ||
| Erythema Production | 327 | ||
| Tanning | 328 | ||
| Epidermal Hyperplasia | 329 | ||
| Vitamin D Synthesis | 329 | ||
| Bactericidal Effects | 329 | ||
| Other Effects of Ultraviolet Radiation | 329 | ||
| Clinical Indications for Ultraviolet Radiation | 330 | ||
| Psoriasis | 330 | ||
| Wound Healing | 331 | ||
| Contraindications and Precautions for Ultraviolet Radiation | 331 | ||
| Contraindications for Ultraviolet Radiation | 331 | ||
| Irradiation of the Eyes | 332 | ||
| Certain Systemic Conditions | 332 | ||
| Precautions for Ultraviolet Radiation | 332 | ||
| Photosensitizing Medications and Dietary Supplements | 332 | ||
| Photosensitivity | 332 | ||
| Recent X-Ray Therapy | 332 | ||
| Erythema From Prior Ultraviolet Dose | 332 | ||
| Adverse Effects of Ultraviolet Radiation | 332 | ||
| Burning | 332 | ||
| Premature Aging of Skin | 332 | ||
| Carcinogenesis | 332 | ||
| Eye Damage | 333 | ||
| Adverse Effects of Psoralen With Ultraviolet a | 333 | ||
| Application Techniques | 333 | ||
| Dose-Response Assessment | 333 | ||
| Dosimetry for the Treatment of Psoriasis With Ultraviolet Radiation | 334 | ||
| Using Ultraviolet B | 335 | ||
| Using Psoralen With Ultraviolet A | 335 | ||
| Documentation | 335 | ||
| Example | 335 | ||
| Ultraviolet Lamps | 336 | ||
| Selecting a Lamp | 336 | ||
| Lamp Maintenance | 337 | ||
| Chapter Review | 338 | ||
| Glossary | 338 | ||
| References | 339 | ||
| VI Mechanical Agents | 341 | ||
| 18 Hydrotherapy | 341 | ||
| Chapter Outline | 341 | ||
| Physical Properties of Water | 342 | ||
| Solvent | 342 | ||
| Resistance | 342 | ||
| Hydrostatic Pressure | 342 | ||
| Buoyancy | 343 | ||
| Specific Heat and Thermal Conductivity | 343 | ||
| Physiological Effects of Hydrotherapy | 344 | ||
| Cleansing | 344 | ||
| Musculoskeletal | 345 | ||
| Cardiovascular | 345 | ||
| Respiratory | 346 | ||
| Renal | 347 | ||
| Psychological | 347 | ||
| Clinical Indications for Hydrotherapy | 348 | ||
| Wound Care | 348 | ||
| Special Concerns Regarding the Use of Hydrotherapy in the Treatment of Burns | 350 | ||
| Negative Pressure Wound Therapy (Vacuum-Assisted Wound Therapy) | 350 | ||
| Edema Control | 351 | ||
| Water Exercise | 351 | ||
| Types of Water Exercise | 351 | ||
| General Uses of Water Exercise | 351 | ||
| Specific Uses of Water Exercise (Box 18.2) | 352 | ||
| Orthopedic Rehabilitation. | 352 | ||
| Neurological Rehabilitation. | 354 | ||
| Cardiorespiratory Fitness. | 354 | ||
| Exercise in Water During Pregnancy. | 354 | ||
| Exercise-Induced Asthma. | 355 | ||
| Age-Related Deficits. | 355 | ||
| Superficial Heating or Cooling | 355 | ||
| Contraindications and Precautions for Hydrotherapy and Negative Pressure Wound Therapy | 355 | ||
| Nonimmersion Hydrotherapy | 355 | ||
| Maceration Around a Wound | 355 | ||
| Recent Skin Grafts | 355 | ||
| May Not Be Effective | 355 | ||
| Negative Pressure Wound Therapy | 355 | ||
| Necrotic Tissue | 355 | ||
| Untreated Osteomyelitis | 356 | ||
| Malignancy | 356 | ||
| Untreated Malnutrition | 356 | ||
| Exposed Arteries, Veins, Nerves, Anastomotic Sites, or Organs | 356 | ||
| Nonenteric and Unexplored Fistulas | 356 | ||
| Anticoagulant Therapy | 356 | ||
| Difficult Hemostasis | 356 | ||
| Confusion or Disorientation | 356 | ||
| Immersion Forms of Hydrotherapy | 356 | ||
| Cardiac Instability | 356 | ||
| Confusion or Impaired Cognition | 357 | ||
| Maceration Around a Wound | 357 | ||
| Bleeding | 357 | ||
| Infection in the Area to Be Immersed | 357 | ||
| Bowel Incontinence | 357 | ||
| Severe Epilepsy | 357 | ||
| Suicidal Patients | 357 | ||
| Impaired Thermal Sensation in the Area to Be Immersed | 357 | ||
| Alcohol Ingestion | 358 | ||
| Limited Strength, Endurance, Balance, or Range of Motion | 358 | ||
| Medications | 358 | ||
| Urinary Incontinence | 358 | ||
| Fear of Water | 358 | ||
| Respiratory Problems | 358 | ||
| Pregnancy | 358 | ||
| Multiple Sclerosis | 358 | ||
| Poor Thermal Regulation | 358 | ||
| Adverse Effects of Hydrotherapy | 359 | ||
| Drowning | 359 | ||
| Burns, Fainting, and Bleeding | 359 | ||
| Hyponatremia | 359 | ||
| Infection | 359 | ||
| Aggravation of Edema | 359 | ||
| Asthma Exacerbation | 359 | ||
| Adverse Effects of Negative Pressure Wound Therapy | 359 | ||
| Application Techniques | 359 | ||
| General Hydrotherapy | 359 | ||
| Nonimmersion Irrigation and Pulsed Lavage | 360 | ||
| Negative Pressure Wound Therapy | 362 | ||
| Exercise Pool | 364 | ||
| Pool Temperature | 364 | ||
| Safety Issues Regarding Hydrotherapy | 365 | ||
| Safety Precautions and Infection Control for Exercise Pools | 365 | ||
| Safety | 365 | ||
| Personnel Training. | 365 | ||
| Safety in and Around the Pool. | 365 | ||
| Infection Control | 366 | ||
| Documentation | 366 | ||
| Examples | 366 | ||
| Chapter Review | 370 | ||
| Glossary | 370 | ||
| General Terms | 370 | ||
| Wound-Related Terms | 370 | ||
| References | 371 | ||
| 19 Traction | 374 | ||
| Chapter Outline | 374 | ||
| Effects of Traction | 375 | ||
| Joint Distraction | 376 | ||
| Reduction of Spinal Disc Protrusion | 376 | ||
| Soft Tissue Stretching | 376 | ||
| Muscle Relaxation | 377 | ||
| Joint Mobilization | 377 | ||
| Clinical Indications for Traction | 377 | ||
| Spinal Disc Bulge or Herniation | 377 | ||
| Spinal Nerve Root Impingement | 377 | ||
| Joint Hypomobility | 378 | ||
| Subacute Joint Inflammation | 378 | ||
| Muscle Spasm | 378 | ||
| Contraindications and Precautions for Traction | 378 | ||
| Contraindications for Traction | 379 | ||
| Where Motion Is Contraindicated | 379 | ||
| Acute Injury or Inflammation | 379 | ||
| Hypermobile or Unstable Joint | 379 | ||
| Peripheralization of Symptoms | 380 | ||
| Uncontrolled Hypertension | 380 | ||
| Precautions for Traction | 380 | ||
| Structural Diseases or Conditions Affecting the Tissues in the Area Being Treated | 380 | ||
| When Pressure From the Belts May Be Hazardous | 380 | ||
| Displaced Annular Fragment | 381 | ||
| Medial Disc Protrusion | 381 | ||
| When Severe Pain Resolves Fully With Traction | 382 | ||
| Claustrophobia or Other Psychological Aversion to Traction | 382 | ||
| Inability to Tolerate the Prone or Supine Position | 382 | ||
| Disorientation | 382 | ||
| Additional Precautions for Cervical Traction | 382 | ||
| Temporomandibular Joint Problems | 382 | ||
| Dentures | 382 | ||
| Adverse Effects of Spinal Traction | 382 | ||
| Application Techniques | 383 | ||
| Mechanical Traction | 383 | ||
| Advantages of Mechanical Traction | 383 | ||
| Disadvantages of Mechanical Traction | 383 | ||
| Motorized Mechanical Traction Units | 383 | ||
| Over-the-Door Cervical Traction Devices | 383 | ||
| Other Home Spinal Traction Devices | 384 | ||
| Mechanical Lumbar Traction | 385 | ||
| Parameters for Mechanical Lumbar Traction | 387 | ||
| Static Versus Intermittent Traction. | 387 | ||
| Hold and Relax Times. | 387 | ||
| Force. | 388 | ||
| Total Treatment Duration. | 388 | ||
| Treatment Frequency. | 388 | ||
| Mechanical Cervical Traction | 388 | ||
| Parameters for Mechanical Cervical Traction | 390 | ||
| Force. | 390 | ||
| Hip Traction With Resistance Band or Traction Device | 391 | ||
| Self-Traction | 392 | ||
| Positional Traction | 394 | ||
| Inversion Traction | 394 | ||
| Manual Traction | 396 | ||
| Documentation | 397 | ||
| Examples | 398 | ||
| Chapter Review | 404 | ||
| Glossary | 404 | ||
| References | 404 | ||
| 20 Compression | 407 | ||
| Chapter Outline | 407 | ||
| Effects of External Compression | 407 | ||
| Improves Venous and Lymphatic Circulation | 407 | ||
| Limits Shape and Size of Tissue | 407 | ||
| Increases Tissue Temperature | 408 | ||
| Clinical Indications for External Compression | 408 | ||
| Edema | 408 | ||
| Causes of Edema | 408 | ||
| Edema Caused by Venous Insufficiency | 408 | ||
| Lymphedema | 409 | ||
| Adverse Consequences of Edema | 411 | ||
| How Compression Reduces Edema | 411 | ||
| Prevention of Deep Venous Thrombosis | 411 | ||
| Venous Stasis Ulcers | 412 | ||
| Residual Limb Shaping After Amputation | 413 | ||
| Control of Hypertrophic Scarring | 413 | ||
| Contraindications and Precautions for External Compression | 414 | ||
| Contraindications for Intermittent or Sequential Compression Pumps | 414 | ||
| Heart Failure or Pulmonary Edema | 414 | ||
| Recent or Acute Deep Venous Thrombosis, Thrombophlebitis, or Pulmonary Embolism | 415 | ||
| Obstructed Lymphatic or Venous Return | 415 | ||
| Severe Peripheral Artery Disease | 415 | ||
| Acute Local Skin Infection | 415 | ||
| Significant Hypoproteinemia | 416 | ||
| Acute Trauma or Fracture | 416 | ||
| Arterial Revascularization | 416 | ||
| Precautions for Intermittent or Sequential Compression Pumps | 416 | ||
| Impaired Sensation or Mentation | 416 | ||
| Uncontrolled Hypertension | 416 | ||
| Cancer | 417 | ||
| Superficial Peripheral Nerves | 417 | ||
| Adverse Effects of External Compression | 417 | ||
| Application Techniques | 417 | ||
| Compression Bandaging | 417 | ||
| Compression Garments | 419 | ||
| Velcro Closure Devices | 422 | ||
| Intermittent Pneumatic Compression Pump | 422 | ||
| Parameters for Intermittent Pneumatic Compression Pumping | 423 | ||
| Inflation and Deflation Times | 423 | ||
| Inflation Pressure | 423 | ||
| Total Treatment Time. | 424 | ||
| Documentation | 425 | ||
| Examples | 426 | ||
| Chapter Review | 430 | ||
| Glossary | 430 | ||
| References | 431 | ||
| Appendix | 433 | ||
| Units of Measure | 433 | ||
| Prefixes for Units | 433 | ||
| Commonly Used Abbreviations and Acronyms | 433 | ||
| Index | 434 | ||
| A | 434 | ||
| B | 434 | ||
| C | 435 | ||
| D | 436 | ||
| E | 437 | ||
| F | 438 | ||
| G | 438 | ||
| H | 438 | ||
| I | 439 | ||
| J | 440 | ||
| K | 440 | ||
| L | 440 | ||
| M | 441 | ||
| N | 442 | ||
| O | 442 | ||
| P | 443 | ||
| Q | 444 | ||
| R | 444 | ||
| S | 444 | ||
| T | 445 | ||
| U | 446 | ||
| V | 447 | ||
| W | 447 | ||
| Z | 448 |