Therapeutic Modalities: For Sports Medicine and Athletic Training / Edition 5

Therapeutic Modalities: For Sports Medicine and Athletic Training / Edition 5

by William E. Prentice
     
 

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ISBN-10: 0072462116

ISBN-13: 9780072462111

Pub. Date: 05/28/2002

Publisher: McGraw-Hill Companies, The

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.

Overview

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.

Product Details

ISBN-13:
9780072462111
Publisher:
McGraw-Hill Companies, The
Publication date:
05/28/2002
Edition description:
Older Edition
Pages:
430

Table of Contents

Preface xi

Contributors xv

Part 1 Foundations of Therapeutic Modalities

1 The Basic Science of Therapeutic Modalities William E. Prentice Bob Blake 2

Forms of Energy 2

Electromagnetic Energy 3

The Relationship between Wavelength and Frequency 4

The Electromagnetic Energy Spectrum 4

How Is Electromagnetic Energy Produced? 6

Effects of Electromagnetic Radiations 7

Laws Governing the Effects of Electromagnetic Energy 7

Electromagnetic Energy Modalities 9

Thermal Energy 10

Thermal Energy Modalities 11

Electrical Energy 11

Electrical Energy Modalities 12

Sound Energy 12

Sound Energy Modalities 12

Mechanical Energy 13

Mechanical Energy Modalities 13

Summary 14

2 Using Therapeutic Modalities to Affect the Healing Process William E. Prentice 17

How Should the Athletic Trainer Use Therapeutic Modalities in Rehabilitation? 17

The Importance of Understanding the Healing Process 19

Inflammatory-Response Phase 19

Fibroplastic-Repair Phase 22

Maturation-Remodeling Phase 23

Factors That Impede Healing 24

How Should Therapeutic Modalities Be Used throughout the Rehabilitation Process? 25

Using Modalities in the Immediate First Aid Management of Injury 25

Modality Use in the Inflammatory-Response Phase 27

Modality Use in the Fibroblastic-Repair Phase 27

Modality Use in the Maturation-Remodeling Phase 28

Other Considerations in Treating Injury 29

Summary 29

3 Managing Pain with Therapeutic Modalities Craig R. Denegar William E. Prentice 33

Understanding Pain 33

Types of Pain 34

Pain Assessment 34

Pain Assessment Scales 35

Goals in Pain Management 38

Pain Perception 38

Sensory Receptors 38

Cognitive Influences 40

NeuralTransmission 40

Facilitators and Inhibitors of Synaptic Transmission 41

Nociception 43

Neurophysiological Explanations of Pain Control 44

The Gate Control Theory of Pain 45

Descending Pain Controls 45

β-endorphin and Dynorphin in Pain Control 46

Summary of Pain Control Mechanisms 48

Pain Management 48

Summary 49

Part 2 Thermal Energy Modalities

4 Cryotherapy and Thermotherapy William E. Prentice 55

Mechanisms of Heat Transfer 57

Appropriate Use of Cryotherapy and Thermotherapy Modalities 57

Clinical Use of the Conductive Energy Modalities 58

Effects of Tissue Temperature Change on Circulation 59

Effects of Tissue Temperature Change on Muscle Spasm 60

Effects of Temperature Change on Performance 61

Cryotherapy 62

Physiologic Effects of Tissue Cooling 62

Cryotherapy Treatment Techniques 65

Thermotherapy 78

Physiologic Effects of Tissue Healing 78

Thermotherapy Treatment Techniques 79

Counterirritants 88

Summary 89

Part 3 Electrical Energy Modalities

5 Basic Principles of Electricity and Electrical Stimulating Currents Daniel N. Hooker William E. Prentice 104

Components of Electrical Currents 104

Electrotherapeutic Currents 107

Generators of Electrotherapeutic Currents 108

Waveforms 109

Waveform Shape 109

Pulses versus Phases and Direction of Current Flow 110

Current Modulation 113

Electrical Circuits 115

Series and Parallel Circuits 115

Current Flow through Biologic Tissues 116

Choosing Appropriate Treatment Parameters 117

Frequency 117

Intensity 118

Duration 118

Polarity 118

Physiologic Responses to Electrical Current 123

Direct and Indirect Physiologic Effects 123

Nerve Responses to Electrical Currents 124

Muscular Responses to Electrical Current 127

Biostimulative Effects of Electrical Current on Nonexcitatory Cells 129

Clinical Uses of Electrical Stimulating Currents 129

High-Volt Currents 129

Asymmetric Biphasic Currents (TENS) 135

Russian Currents (Medium-Frequency Current Generators) 140

Interferential Currents 141

Premodulated Interferential Current 144

Low-Volt Currents 144

Bone Growth Stimulators 145

Placebo Effect of Electrical Stimulation 145

Safety in the Use of Electrical Equipment 146

Summary 148

6 Iontophoresis William E. Prentice 166

Iontophoresis versus Phonophoresis 166

Basic Mechanisms of Ion Transfer 167

Pharmacokinetics of Iontophoresis 167

Movement of Ions in Solution 167

Movement of Ions through Tissue 168

Iontophoresis Equipment and Treatment Techniques 170

Type of Current Required 170

Iontophoresis Generators 170

Current Intensity 170

Treatment Duration 171

Dosage of Medication 171

Electrodes 171

Selecting the Appropriate Ion 173

Clinical Applications for Iontophoresis 175

Treatment Precautions and Contraindications 177

Treatment of Burns 177

Sensitivity Reactions to Ions 178

Summary 178

7 Biofeedback William E. Prentice 185

Electromyography and Biofeedback 185

The Role of Biofeedback 186

Biofeedback Instrumentation 186

Peripheral Skin Temperature 187

Finger Phototransmission 187

Skin Conductance Activity 187

Electromyographic Biofeedback 187

Motor Unit Recruitment 188

Measuring Electrical Activity 188

Separation and Amplification of Electromyographic Activity 189

Converting Electromyographic Activity to Meaningful Information 191

Processing the Electromyographic Signal 191

Biofeedback Equipment and Treatment Techniques 192

Electrodes 192

Displaying the Information 194

Clinical Applications for Biofeedback 195

Muscle Reeducation 195

Relaxation of Muscle Guarding 196

Pain Reduction 197

Treating Neurologic Conditions 197

Summary 198

Part 4 Sound Energy Modalities

8 Therapeutic Ultrasound David O. Draper William E. Prentice 206

Ultrasound as a Heating Modality 207

Transmission of Acoustic Energy in Biologic Tissues 207

Transverse versus Longitudinal Waves 207

Frequency of Wave Transmission 208

Velocity 209

Attenuation 209

Basic Principles of Therapeutic Ultrasound 210

Components of a Therapeutic Ultrasound Generator 210

Physiologic Effects of Ultrasound 219

Thermal Effects 219

Nonthermal Effects 220

Ultrasound Treatment Techniques 221

Frequency of Treatment 221

Duration of Treatment 222

Coupling Methods 223

Exposure Techniques 224

Clinical Applications for Therapeutic Ultrasound 228

Soft-Tissue Healing and Repair 228

Scar Tissue and Joint Contracture 229

Stretching of Connective Tissue 229

Chronic Inflammation 230

Bone Healing 231

Pain Reduction 232

Plantar Warts 232

Placebo Effects 232

Phonophoresis 232

Using Ultrasound in Combination with Other Modalities 236

Ultrasound and Hot Packs 236

Ultrasound and Cold Packs 236

Ultrasound and Electrical Stimulation 237

Treatment Precautions 238

Guidelines for the Safe Use of Ultrasound Equipment 240

Summary 240

Part 5 Electromagnetic Energy Modalities

9 Low-Level Laser Therapy Ethan Saliba Susan Foreman-Saliba 256

Physics 257

Types of Lasers 258

Laser Treatment Techniques 259

Lasing Techniques 260

Dosage 261

Depth of Penetration 262

Clinical Applications for Lasers 263

Wound Healing 263

Pain 266

Bone Response 266

Suggested Treatment Protocols 266

Pain 267

Wound Healing 268

Scar Tissue 268

Edema and Inflammation 268

Safety 268

Precautions and Contraindications 270

Conclusion 270

Summary 270

10 Shortwave and Microwave Diathermy William E. Prentice David O. Draper 276

Physiologic Responses to Diathermy 277

Thermal Effects 277

Nonthermal Effects 277

Shortwave Diathermy Equipment 278

Shortwave Diathermy Electrodes 280

Pulsed Shortwave Diathermy 285

Treatment Time 286

Microwave Diathermy 287

Clinical Applications for Diathermy 288

Comparing Shortwave Diathermy and Ultrasound as Thermal Modalities 289

Diathermy Treatment Precautions, Indications, and Contraindications 290

Summary 292

Part 6 Mechanical Energy Modalities

11 Intermittent Compression Devices Daniel N. Hooker 304

The Lymphatic System 305

Purposes of the Lymphatic System 305

Structure of the Lymphatic System 305

Peripheral Lymphatic Structure and Function 306

Injury Edema 307

Formation of Pitting Edema 307

Formation of Lymphedema 307

The Negative Effects of Edema Accumulation 308

Treatment of Edema 308

Intermittent Compression Treatment Techniques 310

Inflation Pressures 310

On-Off Sequence 311

Total Treatment Time 311

Sequential Compression Pumps 312

Patient Setup and Instructions 313

Cold and Compression Combination 314

Indications and Contraindications for Use 314

Summary 316

12 Spinal Traction Daniel N. Hooker 322

The Physical Effects of Traction 322

Effects on Spinal Movement 322

Effects on Bone 323

Effects on Ligaments 323

Effects on the Disk 324

Effects on Articular Facet Joints 325

Effects on the Muscular System 325

Effects on the Nerves 326

Effects on the Entire Body Part 326

Traction Treatment Techniques 326

Lumbar Positional Traction 327

Inversion Traction 328

Manual Lumbar Traction 330

Level-Specific Manual Traction 331

Unilateral Leg Pull Manual Traction 332

Mechanical Lumbar Traction 332

Patient Setup and Equipment 333

Body Position 334

Traction Force 336

Intermittent versus Sustained Traction 337

Duration of Treatment 338

Progressive and Regressive Steps 338

Manual Cervical Traction 339

Mechanical Cervical Traction 341

Indications and Contraindications 342

Summary 343

13 Therapeutic Sports Massage William E. Prentice 349

The Evolution of Massage as a Treatment Modality 349

Physiologic Effects of Massage 350

Reflexive Effects 351

Mechanical Effects 351

Psychological Effects of Massage 352

Massage Treatment Considerations and Guidelines 352

Equipment 354

Preparation of the Patient 355

Massage Treatment Techniques 356

Hoffa Massage 356

Friction Massage 360

Transverse Friction Massage 361

Connective Tissue Massage 361

Trigger Point Massage 363

Strain-Counterstrain 365

Positional Release Therapy 365

Active Release Technique 366

Myofascial Release 367

Graston Technique® 368

Rolfing 370

Trager 371

Indications and Contraindications for Massage 371

Summary 372

Appendixes A-1

A Location of the Motor Points A-1

B Units of Measure A-5

C Answers to Self-Quizzes A-6

Glossary G-1

Credits C-1

Index I-1

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