Therapeutic Modalities: For Sports Medicine and Athletic Training w/ eSims

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  • Edition: 6th
  • Format: Hardcover
  • Copyright: 6/2/2008
  • Publisher: McGraw-Hill Humanities/Social Sciences/Languages

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This text is a contributed work by well-known trainers and educators, written under the direction of Dr. Prentice. The 6th edition continues to be the only text developed specifically for athletic trainers. This text is also appropriate for those physical therapists that are involved in a sports medicine curriculum.

Table of Contents

Prefacep. xi
Contributorsp. xv
Foundations of Therapeutic Modalities
The Basic Science of Therapeutic Modalitiesp. 2
Forms of Energyp. 2
Electromagnetic Energyp. 3
The Relationship between Wavelength and Frequencyp. 4
The Electromagnetic Energy Spectrump. 4
How Is Electromagnetic Energy Produced?p. 6
Effects of Electromagnetic Radiationsp. 7
Laws Governing the Effects of Electromagnetic Energyp. 7
Electromagnetic Energy Modalitiesp. 9
Thermal Energyp. 10
Thermal Energy Modalitiesp. 11
Electrical Energyp. 11
Electrical Energy Modalitiesp. 12
Sound Energyp. 12
Sound Energy Modalitiesp. 12
Mechanical Energyp. 13
Mechanical Energy Modalitiesp. 13
Summaryp. 14
Using Therapeutic Modalities to Affect the Healing Processp. 17
How Should the Athletic Trainer Use Therapeutic Modalities in Rehabilitation?p. 17
The Importance of Understanding the Healing Processp. 19
Inflammatory-Response Phasep. 19
Fibroplastic-Repair Phasep. 22
Maturation-Remodeling Phasep. 23
Factors That Impede Healingp. 24
How Should Therapeutic Modalities Be Used throughout the Rehabilitation Process?p. 25
Using Modalities in the Immediate First Aid Management of Injuryp. 25
Modality Use in the Inflammatory-Response Phasep. 27
Modality Use in the Fibroblastic-Repair Phasep. 27
Modality Use in the Maturation-Remodeling Phasep. 28
Other Considerations in Treating Injuryp. 29
Summaryp. 29
Managing Pain with Therapeutic Modalitiesp. 33
Understanding Painp. 33
Types of Painp. 34
Pain Assessmentp. 34
Pain Assessment Scalesp. 35
Goals in Pain Managementp. 38
Pain Perceptionp. 38
Sensory Receptorsp. 38
Cognitive Influencesp. 40
Neural Transmissionp. 40
Facilitators and Inhibitors of Synaptic Transmissionp. 41
Nociceptionp. 43
Neurophysiological Explanations of Pain Controlp. 44
The Gate Control Theory of Painp. 45
Descending Pain Controlsp. 45
ß-endorphin and Dynorphin in Pain Controlp. 46
Summary of Pain Control Mechanismsp. 48
Pain Managementp. 48
Summaryp. 49
Thermal Energy Modalities
Cryotherapy and Thermotherapyp. 55
Mechanisms of Heat Transferp. 57
Appropriate Use of Cryotherapy and Thermotherapy Modalitiesp. 57
Clinical Use of the Conductive Energy Modalitiesp. 58
Effects of Tissue Temperature Change on Circulationp. 59
Effects of Tissue Temperature Change on Muscle Spasmp. 60
Effects of Temperature Change on Performancep. 61
Cryotherapyp. 62
Physiologic Effects of Tissue Coolingp. 62
Cryotherapy Treatment Techniquesp. 65
Thermotherapyp. 78
Physiologic Effects of Tissue Healingp. 78
Thermotherapy Treatment Techniquesp. 79
Counterirritantsp. 88
Summaryp. 89
Electrical Energy Modalities
Basic Principles of Electricity and Electrical Stimulating Currentsp. 104
Components of Electrical Currentsp. 104
Electrotherapeutic Currentsp. 107
Generators of Electrotherapeutic Currentsp. 108
Waveformsp. 109
Waveform Shapep. 109
Pulses versus Phases and Direction of Current Flowp. 110
Current Modulationp. 113
Electrical Circuitsp. 115
Series and Parallel Circuitsp. 115
Current Flow through Biologic Tissuesp. 116
Choosing Appropriate Treatment Parametersp. 117
Frequencyp. 117
Intensityp. 118
Durationp. 118
Polarityp. 118
Physiologic Responses to Electrical Currentp. 123
Direct and Indirect Physiologic Effectsp. 123
Nerve Responses to Electrical Currentsp. 124
Muscular Responses to Electrical Currentp. 127
Biostimulative Effects of Electrical Current on Nonexcitatory Cellsp. 129
Clinical Uses of Electrical Stimulating Currentsp. 129
High-Volt Currentsp. 129
Asymmetric Biphasic Currents (TENS)p. 135
Russian Currents (Medium-Frequency Current Generators)p. 140
Interferential Currentsp. 141
Premodulated Interferential Currentp. 144
Low-Volt Currentsp. 144
Bone Growth Stimulatorsp. 145
Placebo Effect of Electrical Stimulationp. 145
Safety in the Use of Electrical Equipmentp. 146
Summaryp. 148
Iontophoresisp. 166
Iontophoresis versus Phonophoresisp. 166
Basic Mechanisms of Ion Transferp. 167
Pharmacokinetics of Iontophoresisp. 167
Movement of Ions in Solutionp. 167
Movement of Ions through Tissuep. 168
Iontophoresis Equipment and Treatment Techniquesp. 170
Type of Current Requiredp. 170
Iontophoresis Generatorsp. 170
Current Intensityp. 170
Treatment Durationp. 171
Dosage of Medicationp. 171
Electrodesp. 171
Selecting the Appropriate Ionp. 173
Clinical Applications for Iontophoresisp. 175
Treatment Precautions and Contraindicationsp. 177
Treatment of Burnsp. 177
Sensitivity Reactions to Ionsp. 178
Summaryp. 178
Biofeedbackp. 185
Electromyography and Biofeedbackp. 185
The Role of Biofeedbackp. 186
Biofeedback Instrumentationp. 186
Peripheral Skin Temperaturep. 187
Finger Phototransmissionp. 187
Skin Conductance Activityp. 187
Electromyographic Biofeedbackp. 187
Motor Unit Recruitmentp. 188
Measuring Electrical Activityp. 188
Separation and Amplification of Electromyographic Activityp. 189
Converting Electromyographic Activity to Meaningful Informationp. 191
Processing the Electromyographic Signalp. 191
Biofeedback Equipment and Treatment Techniquesp. 192
Electrodesp. 192
Displaying the Informationp. 194
Clinical Applications for Biofeedbackp. 195
Muscle Reeducationp. 195
Relaxation of Muscle Guardingp. 196
Pain Reductionp. 197
Treating Neurologic Conditionsp. 197
Summaryp. 198
Sound Energy Modalities
Therapeutic Ultrasoundp. 206
Ultrasound as a Heating Modalityp. 207
Transmission of Acoustic Energy in Biologic Tissuesp. 207
Transverse versus Longitudinal Wavesp. 207
Frequency of Wave Transmissionp. 208
Velocityp. 209
Attenuationp. 209
Basic Principles of Therapeutic Ultrasoundp. 210
Components of a Therapeutic Ultrasound Generatorp. 210
Physiologic Effects of Ultrasoundp. 219
Thermal Effectsp. 219
Nonthermal Effectsp. 220
Ultrasound Treatment Techniquesp. 221
Frequency of Treatmentp. 221
Duration of Treatmentp. 222
Coupling Methodsp. 223
Exposure Techniquesp. 224
Clinical Applications for Therapeutic Ultrasoundp. 228
Soft-Tissue Healing and Repairp. 228
Scar Tissue and Joint Contracturep. 229
Stretching of Connective Tissuep. 229
Chronic Inflammationp. 230
Bone Healingp. 231
Pain Reductionp. 232
Plantar Wartsp. 232
Placebo Effectsp. 232
Phonophoresisp. 232
Using Ultrasound in Combination with Other Modalitiesp. 236
Ultrasound and Hot Packsp. 236
Ultrasound and Cold Packsp. 236
Ultrasound and Electrical Stimulationp. 237
Treatment Precautionsp. 238
Guidelines for the Safe Use of Ultrasound Equipmentp. 240
Summaryp. 240
Electromagnetic Energy Modalities
Low-Level Laser Therapyp. 256
Physicsp. 257
Types of Lasersp. 258
Laser Treatment Techniquesp. 259
Lasing Techniquesp. 260
Dosagep. 261
Depth of Penetrationp. 262
Clinical Applications for Lasersp. 263
Wound Healingp. 263
Painp. 266
Bone Responsep. 266
Suggested Treatment Protocolsp. 266
Painp. 267
Wound Healingp. 268
Scar Tissuep. 268
Edema and Inflammationp. 268
Safetyp. 268
Precautions and Contraindicationsp. 270
Conclusionp. 270
Summaryp. 270
Shortwave and Microwave Diathermyp. 276
Physiologic Responses to Diathermyp. 277
Thermal Effectsp. 277
Nonthermal Effectsp. 277
Shortwave Diathermy Equipmentp. 278
Shortwave Diathermy Electrodesp. 280
Pulsed Shortwave Diathermyp. 285
Treatment Timep. 286
Microwave Diathermyp. 287
Clinical Applications for Diathermyp. 288
Comparing Shortwave Diathermy and Ultrasound as Thermal Modalitiesp. 289
Diathermy Treatment Precautions, Indications, and Contraindicationsp. 290
Summaryp. 292
Mechanical Energy Modalities
Intermittent Compression Devicesp. 304
The Lymphatic Systemp. 305
Purposes of the Lymphatic Systemp. 305
Structure of the Lymphatic Systemp. 305
Peripheral Lymphatic Structure and Functionp. 306
Injury Edemap. 307
Formation of Pitting Edemap. 307
Formation of Lymphedemap. 307
The Negative Effects of Edema Accumulationp. 308
Treatment of Edemap. 308
Intermittent Compression Treatment Techniquesp. 310
Inflation Pressuresp. 310
On-Off Sequencep. 311
Total Treatment Timep. 311
Sequential Compression Pumpsp. 312
Patient Setup and Instructionsp. 313
Cold and Compression Combinationp. 314
Indications and Contraindications for Usep. 314
Summaryp. 316
Spinal Tractionp. 322
The Physical Effects of Tractionp. 322
Effects on Spinal Movementp. 322
Effects on Bonep. 323
Effects on Ligamentsp. 323
Effects on the Diskp. 324
Effects on Articular Facet Jointsp. 325
Effects on the Muscular Systemp. 325
Effects on the Nervesp. 326
Effects on the Entire Body Partp. 326
Traction Treatment Techniquesp. 326
Lumbar Positional Tractionp. 327
Inversion Tractionp. 328
Manual Lumbar Tractionp. 330
Level-Specific Manual Tractionp. 331
Unilateral Leg Pull Manual Tractionp. 332
Mechanical Lumbar Tractionp. 332
Patient Setup and Equipmentp. 333
Body Positionp. 334
Traction Forcep. 336
Intermittent versus Sustained Tractionp. 337
Duration of Treatmentp. 338
Progressive and Regressive Stepsp. 338
Manual Cervical Tractionp. 339
Mechanical Cervical Tractionp. 341
Indications and Contraindicationsp. 342
Summaryp. 343
Therapeutic Sports Massagep. 349
The Evolution of Massage as a Treatment Modalityp. 349
Physiologic Effects of Massagep. 350
Reflexive Effectsp. 351
Mechanical Effectsp. 351
Psychological Effects of Massagep. 352
Massage Treatment Considerations and Guidelinesp. 352
Equipmentp. 354
Preparation of the Patientp. 355
Massage Treatment Techniquesp. 356
Hoffa Massagep. 356
Friction Massagep. 360
Transverse Friction Massagep. 361
Connective Tissue Massagep. 361
Trigger Point Massagep. 363
Strain-Counterstrainp. 365
Positional Release Therapyp. 365
Active Release Techniquep. 366
Myofascial Releasep. 367
Graston Technique®p. 368
Rolfingp. 370
Tragerp. 371
Indications and Contraindications for Massagep. 371
Summaryp. 372
Appendixesp. A-1
Location of the Motor Pointsp. A-1
Units of Measurep. A-5
Answers to Self-Quizzesp. A-6
Glossaryp. G-1
Creditsp. C-1
Indexp. I-1
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