物理因子疗法T

• Biofeedback • Light energies
Laser Ultra-violet (uv)
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For each EPT modality you need to know
• Principles of how energy is generated and how it is delivered into the body • Indications for its use • Physiological effects • Therapeutic effects • Contraindications and precautions • Methods of application • Outcome evaluation and progression of treatment
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EPT Application Process 2. ExpIain Rx, effects and consent
• Fully inform patient all relevant aspects of treatment • advice on explanation (selection of the modality and its possible benefits and potential risks) and warnings • Obtain valid consent
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Electrophysical Therapy
• Normal physiological process
promote soft tissue healing after a muscle strain by heating Limit secondary damage from normal bleeding and oedema in damaged tissue by cooling
• Proliferative Phase
Fibroplasia，collagen production， angiogenesis， wound contraction
• Remodelling Phase
Laying down of immature scar tissue Orientation of collagen fibres along lines of stress
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Electro-Physical Therapy
• Electro Use of electricity • Physical use of physical energy, like heat, cold, light • Application of external energy which can beneficially alter physiological process
• 2 types of tests
“Hot and cold ” test
for any thermal agent e.g. hot pack, infrared, wax, ice, shortwave, US
“Sharp and blunt ” or “pin-prick” test
for ice, ES, US
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Classification of EPT Agents
• Superficial thermal agents
Hot pack (HP) Wax Infrared radiation (IRR)
• Deep thermal agents
Short wave diathermy (SWD) Microwave (MW) Pulsed electromagnetic field (PEMF) Ultrasound (US)
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EPT Application Process 1. Introduce yourself
• “Hello Mr. X, I am your physiotherapist. My name is Y….” • Discuss treatment options with patient after assessment and selection of a modality
the heat treatment . I have 2 test tubes here with hot and cold water. This is hot (let the patient feel the test tube with hot water) and this is cold (let the patient feel the test tube with cold water) . I want you to close your eyes now and I will place the test tube onto your skin. Tell me whether you feel hot or cold.”
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EPT Application Process 2. ExpIain Rx, effects and consent
“After the assessment , I would suggest to use heat pack for your low back pain . The heat will improve the blood flow and reduce muscle spasm of your lower back muscles. It can also help to relieve the pain….Do you agree to receive this treatment? ”
• Skin
Normal sensation ? rash, infection, allergy, open wound , eczema
• Circulation
Peripheral vascular disease (PVD), deep vein thrombosis (DVT), varicose veins
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EPT Application Process
• Introduce yourself to the patient • Explain treatment options, effects and obtain valid consent from the patient. • Ask contraindications • Position patient • Perform skin sensation tests • Prepare equipment and test machine • Apply treatment • End of treatment
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Process of Tissue Repair
3 phase of tissue repair Inflammatory
acute(24-48hrs) and subacute (10-14days)
Proliferative
Fibroplasis, angiogenesis, wound contraction (3-4 weeks)
Remodelling
remodelling of collagen fibres (3 wks-months) Each phase has different physiological process and heat may be useful in some phases and not others
Transcutaneous electrical nerve stimulation (TENS) Interferential therapy (IFT)
• ES for Neurological conditions
Denervated Muscles e.g. strength duration curve (SDC), interrupted direct current (IDC) Functional electrical stimulation (FES) for stroke patients
Introduction to Electrophysical Therapy
College of Rehabilitation Medicine，FuJian University of Traditional Chinese Medicine Octorber 13, 2010
Qinglu LUO
• Pain reduction
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Electrophysical therapy (EPT) is an integral part of physiotherapy assessment or treatment regime, to achieve therapeutic benefits for patients
• Delayed healing process
Electrical stimulation to increase the rate of healing in some types of wound
• Supplementing normal learning or relearning
Biofeedback or electrical stimulation e.g. NMES
• Mental status • Medications • Others
pregnancy
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EPT Application Process 4. Position patient
• Position patient properly • Consider ease of application of modality , comfort, stability and safety. • Ensure privacy of the patient “ I will apply the hot pack over your lower back with you lying on your tummy.”
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Fig 1.1 Time scale of the healing process
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Response to Injury ： Process of Tissue Healing
• Inflammatory phase
Haemorrhage and fluid loss Brief vasoconstriction and blood clotting Inflammatory cells migrate in Chemical factors released
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EPT Application Process 5.perform skin sensation test
• Explain clearly the purpose of the test and what the patient is expected to feel
“ I will now check your skin sensation to make sure that it is safe to apply
• Cryotherapy
Ice, cold
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Classification of EPT Agents
• Electrical Stimulation (ES) • Neuro-Muscular Electrical StimuBaidu Nhomakorabeaation (NMES) • ES for pain management
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EPT Application Process 3. Ask for contraindication
• General health
Heart, any serious disease (e.g. DM), any major surgery (e.g. implanted electronic devices), fever
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EPT Application Process 5.perform skin sensation test
• Therapist has an obligation to ensure the patient has normal skin sensation before commencing any EPT