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

by Prentice, William

• ISBN13: 9780077236335
• ISBN10: 0077236335
• Edition: 6th
• Format: Hardcover
• Copyright: 2008-06-02
• Publisher: MCGRAW HILL

Summary

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

Preface	p. xi
Contributors	p. xv
Foundations of Therapeutic Modalities
The Basic Science of Therapeutic Modalities	p. 2
Forms of Energy	p. 2
Electromagnetic Energy	p. 3
The Relationship between Wavelength and Frequency	p. 4
The Electromagnetic Energy Spectrum	p. 4
How Is Electromagnetic Energy Produced?	p. 6
Effects of Electromagnetic Radiations	p. 7
Laws Governing the Effects of Electromagnetic Energy	p. 7
Electromagnetic Energy Modalities	p. 9
Thermal Energy	p. 10
Thermal Energy Modalities	p. 11
Electrical Energy	p. 11
Electrical Energy Modalities	p. 12
Sound Energy	p. 12
Sound Energy Modalities	p. 12
Mechanical Energy	p. 13
Mechanical Energy Modalities	p. 13
Summary	p. 14
Using Therapeutic Modalities to Affect the Healing Process	p. 17
How Should the Athletic Trainer Use Therapeutic Modalities in Rehabilitation?	p. 17
The Importance of Understanding the Healing Process	p. 19
Inflammatory-Response Phase	p. 19
Fibroplastic-Repair Phase	p. 22
Maturation-Remodeling Phase	p. 23
Factors That Impede Healing	p. 24
How Should Therapeutic Modalities Be Used throughout the Rehabilitation Process?	p. 25
Using Modalities in the Immediate First Aid Management of Injury	p. 25
Modality Use in the Inflammatory-Response Phase	p. 27
Modality Use in the Fibroblastic-Repair Phase	p. 27
Modality Use in the Maturation-Remodeling Phase	p. 28
Other Considerations in Treating Injury	p. 29
Summary	p. 29
Managing Pain with Therapeutic Modalities	p. 33
Understanding Pain	p. 33
Types of Pain	p. 34
Pain Assessment	p. 34
Pain Assessment Scales	p. 35
Goals in Pain Management	p. 38
Pain Perception	p. 38
Sensory Receptors	p. 38
Cognitive Influences	p. 40
Neural Transmission	p. 40
Facilitators and Inhibitors of Synaptic Transmission	p. 41
Nociception	p. 43
Neurophysiological Explanations of Pain Control	p. 44
The Gate Control Theory of Pain	p. 45
Descending Pain Controls	p. 45
ß-endorphin and Dynorphin in Pain Control	p. 46
Summary of Pain Control Mechanisms	p. 48
Pain Management	p. 48
Summary	p. 49
Thermal Energy Modalities
Cryotherapy and Thermotherapy	p. 55
Mechanisms of Heat Transfer	p. 57
Appropriate Use of Cryotherapy and Thermotherapy Modalities	p. 57
Clinical Use of the Conductive Energy Modalities	p. 58
Effects of Tissue Temperature Change on Circulation	p. 59
Effects of Tissue Temperature Change on Muscle Spasm	p. 60
Effects of Temperature Change on Performance	p. 61
Cryotherapy	p. 62
Physiologic Effects of Tissue Cooling	p. 62
Cryotherapy Treatment Techniques	p. 65
Thermotherapy	p. 78
Physiologic Effects of Tissue Healing	p. 78
Thermotherapy Treatment Techniques	p. 79
Counterirritants	p. 88
Summary	p. 89
Electrical Energy Modalities
Basic Principles of Electricity and Electrical Stimulating Currents	p. 104
Components of Electrical Currents	p. 104
Electrotherapeutic Currents	p. 107
Generators of Electrotherapeutic Currents	p. 108
Waveforms	p. 109
Waveform Shape	p. 109
Pulses versus Phases and Direction of Current Flow	p. 110
Current Modulation	p. 113
Electrical Circuits	p. 115
Series and Parallel Circuits	p. 115
Current Flow through Biologic Tissues	p. 116
Choosing Appropriate Treatment Parameters	p. 117
Frequency	p. 117
Intensity	p. 118
Duration	p. 118
Polarity	p. 118
Physiologic Responses to Electrical Current	p. 123
Direct and Indirect Physiologic Effects	p. 123
Nerve Responses to Electrical Currents	p. 124
Muscular Responses to Electrical Current	p. 127
Biostimulative Effects of Electrical Current on Nonexcitatory Cells	p. 129
Clinical Uses of Electrical Stimulating Currents	p. 129
High-Volt Currents	p. 129
Asymmetric Biphasic Currents (TENS)	p. 135
Russian Currents (Medium-Frequency Current Generators)	p. 140
Interferential Currents	p. 141
Premodulated Interferential Current	p. 144
Low-Volt Currents	p. 144
Bone Growth Stimulators	p. 145
Placebo Effect of Electrical Stimulation	p. 145
Safety in the Use of Electrical Equipment	p. 146
Summary	p. 148
Iontophoresis	p. 166
Iontophoresis versus Phonophoresis	p. 166
Basic Mechanisms of Ion Transfer	p. 167
Pharmacokinetics of Iontophoresis	p. 167
Movement of Ions in Solution	p. 167
Movement of Ions through Tissue	p. 168
Iontophoresis Equipment and Treatment Techniques	p. 170
Type of Current Required	p. 170
Iontophoresis Generators	p. 170
Current Intensity	p. 170
Treatment Duration	p. 171
Dosage of Medication	p. 171
Electrodes	p. 171
Selecting the Appropriate Ion	p. 173
Clinical Applications for Iontophoresis	p. 175
Treatment Precautions and Contraindications	p. 177
Treatment of Burns	p. 177
Sensitivity Reactions to Ions	p. 178
Summary	p. 178
Biofeedback	p. 185
Electromyography and Biofeedback	p. 185
The Role of Biofeedback	p. 186
Biofeedback Instrumentation	p. 186
Peripheral Skin Temperature	p. 187
Finger Phototransmission	p. 187
Skin Conductance Activity	p. 187
Electromyographic Biofeedback	p. 187
Motor Unit Recruitment	p. 188
Measuring Electrical Activity	p. 188
Separation and Amplification of Electromyographic Activity	p. 189
Converting Electromyographic Activity to Meaningful Information	p. 191
Processing the Electromyographic Signal	p. 191
Biofeedback Equipment and Treatment Techniques	p. 192
Electrodes	p. 192
Displaying the Information	p. 194
Clinical Applications for Biofeedback	p. 195
Muscle Reeducation	p. 195
Relaxation of Muscle Guarding	p. 196
Pain Reduction	p. 197
Treating Neurologic Conditions	p. 197
Summary	p. 198
Sound Energy Modalities
Therapeutic Ultrasound	p. 206
Ultrasound as a Heating Modality	p. 207
Transmission of Acoustic Energy in Biologic Tissues	p. 207
Transverse versus Longitudinal Waves	p. 207
Frequency of Wave Transmission	p. 208
Velocity	p. 209
Attenuation	p. 209
Basic Principles of Therapeutic Ultrasound	p. 210
Components of a Therapeutic Ultrasound Generator	p. 210
Physiologic Effects of Ultrasound	p. 219
Thermal Effects	p. 219
Nonthermal Effects	p. 220
Ultrasound Treatment Techniques	p. 221
Frequency of Treatment	p. 221
Duration of Treatment	p. 222
Coupling Methods	p. 223
Exposure Techniques	p. 224
Clinical Applications for Therapeutic Ultrasound	p. 228
Soft-Tissue Healing and Repair	p. 228
Scar Tissue and Joint Contracture	p. 229
Stretching of Connective Tissue	p. 229
Chronic Inflammation	p. 230
Bone Healing	p. 231
Pain Reduction	p. 232
Plantar Warts	p. 232
Placebo Effects	p. 232
Phonophoresis	p. 232
Using Ultrasound in Combination with Other Modalities	p. 236
Ultrasound and Hot Packs	p. 236
Ultrasound and Cold Packs	p. 236
Ultrasound and Electrical Stimulation	p. 237
Treatment Precautions	p. 238
Guidelines for the Safe Use of Ultrasound Equipment	p. 240
Summary	p. 240
Electromagnetic Energy Modalities
Low-Level Laser Therapy	p. 256
Physics	p. 257
Types of Lasers	p. 258
Laser Treatment Techniques	p. 259
Lasing Techniques	p. 260
Dosage	p. 261
Depth of Penetration	p. 262
Clinical Applications for Lasers	p. 263
Wound Healing	p. 263
Pain	p. 266
Bone Response	p. 266
Suggested Treatment Protocols	p. 266
Pain	p. 267
Wound Healing	p. 268
Scar Tissue	p. 268
Edema and Inflammation	p. 268
Safety	p. 268
Precautions and Contraindications	p. 270
Conclusion	p. 270
Summary	p. 270
Shortwave and Microwave Diathermy	p. 276
Physiologic Responses to Diathermy	p. 277
Thermal Effects	p. 277
Nonthermal Effects	p. 277
Shortwave Diathermy Equipment	p. 278
Shortwave Diathermy Electrodes	p. 280
Pulsed Shortwave Diathermy	p. 285
Treatment Time	p. 286
Microwave Diathermy	p. 287
Clinical Applications for Diathermy	p. 288
Comparing Shortwave Diathermy and Ultrasound as Thermal Modalities	p. 289
Diathermy Treatment Precautions, Indications, and Contraindications	p. 290
Summary	p. 292
Mechanical Energy Modalities
Intermittent Compression Devices	p. 304
The Lymphatic System	p. 305
Purposes of the Lymphatic System	p. 305
Structure of the Lymphatic System	p. 305
Peripheral Lymphatic Structure and Function	p. 306
Injury Edema	p. 307
Formation of Pitting Edema	p. 307
Formation of Lymphedema	p. 307
The Negative Effects of Edema Accumulation	p. 308
Treatment of Edema	p. 308
Intermittent Compression Treatment Techniques	p. 310
Inflation Pressures	p. 310
On-Off Sequence	p. 311
Total Treatment Time	p. 311
Sequential Compression Pumps	p. 312
Patient Setup and Instructions	p. 313
Cold and Compression Combination	p. 314
Indications and Contraindications for Use	p. 314
Summary	p. 316
Spinal Traction	p. 322
The Physical Effects of Traction	p. 322
Effects on Spinal Movement	p. 322
Effects on Bone	p. 323
Effects on Ligaments	p. 323
Effects on the Disk	p. 324
Effects on Articular Facet Joints	p. 325
Effects on the Muscular System	p. 325
Effects on the Nerves	p. 326
Effects on the Entire Body Part	p. 326
Traction Treatment Techniques	p. 326
Lumbar Positional Traction	p. 327
Inversion Traction	p. 328
Manual Lumbar Traction	p. 330
Level-Specific Manual Traction	p. 331
Unilateral Leg Pull Manual Traction	p. 332
Mechanical Lumbar Traction	p. 332
Patient Setup and Equipment	p. 333
Body Position	p. 334
Traction Force	p. 336
Intermittent versus Sustained Traction	p. 337
Duration of Treatment	p. 338
Progressive and Regressive Steps	p. 338
Manual Cervical Traction	p. 339
Mechanical Cervical Traction	p. 341
Indications and Contraindications	p. 342
Summary	p. 343
Therapeutic Sports Massage	p. 349
The Evolution of Massage as a Treatment Modality	p. 349
Physiologic Effects of Massage	p. 350
Reflexive Effects	p. 351
Mechanical Effects	p. 351
Psychological Effects of Massage	p. 352
Massage Treatment Considerations and Guidelines	p. 352
Equipment	p. 354
Preparation of the Patient	p. 355
Massage Treatment Techniques	p. 356
Hoffa Massage	p. 356
Friction Massage	p. 360
Transverse Friction Massage	p. 361
Connective Tissue Massage	p. 361
Trigger Point Massage	p. 363
Strain-Counterstrain	p. 365
Positional Release Therapy	p. 365
Active Release Technique	p. 366
Myofascial Release	p. 367
Graston Technique®	p. 368
Rolfing	p. 370
Trager	p. 371
Indications and Contraindications for Massage	p. 371
Summary	p. 372
Appendixes	p. A-1
Location of the Motor Points	p. A-1
Units of Measure	p. A-5
Answers to Self-Quizzes	p. A-6
Glossary	p. G-1
Credits	p. C-1
Index	p. I-1
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