Korea Univ. Col of Healthscience Depart.of Physical Therapy Eun hye Kim, PT, Ph.D course Phototherapy & Electrotherapy (1)

김은혜

전기의 물리적 특성과 전기가 생체의 미치는 영향을 연구하고 전기 를 이용한 각종 치료법들의 원리와 적용방법을 연구한다. 수업진행 방식 - 강의 80%, 실습 20% 학습평가방법 - 중간고사 30%, 기말고사 40 %, 출석 20%, 과제물 10%, 기타 10% 교재 및 참고도서 등록 교재 _ 최신 전기치료학 ( 이재형외 ) 부교재 _Electrotherapy evidence-based practice (Sheila Kitchen)

강의계획 주주 별 주제주 1Orientation9 직류전기자극, 이온도입 2 전기치료의 개요, 전기물리학 10 탈신경근육의 전기자극, 신경지배 근의 전기자극 3 의용전류 11 간섭전류치료, 고전압맥동전류자극 치료 4 전기치료기기 12 경피신경자극치료, 심부조직 전기 자극 5 전기생리학 13 조직치유 전기자극, 고주파심부투 열치료 6 조직치유 14 초음파, 레이저 7 중간고사 15 기말고사 8 전기 진단학 16

Recent focus on PT Evidence-based science ◦ Why? Interchange or communicate between PT and other studies, such as Medical part, nursing, athletics Limitation : PT material is regarded as subject method ◦ The range of therapeutic ability among this group is so diverse. Thus, it is hard to make a standard application for treatment. Find the mechanism of PT effects ◦ PT modalities, manipulation, PT exercise

전기치료의 개요 치료 프로토콜의 도출과 발전

When Do You Use Therapeutic Modalities? For First Aid Immediately Following Injury For First Aid Immediately Following Injury Throughout The Injury Rehabilitation Process Throughout The Injury Rehabilitation Process For First Aid Immediately Following Injury For First Aid Immediately Following Injury Throughout The Injury Rehabilitation Process Throughout The Injury Rehabilitation Process

Physical Agents ◦ Heat ◦ Cold ◦ Water ◦ Mechanical modalities  Pressure  Vibration  Traction ◦ Sound ◦ Electrical Current

Commonly used modalities Temperature modalities ◦ Cryotherapy - ice ◦ Heat  Superficial – hot packs & Infra-red  Deep – Ultrasound micro wave diathermy, short wave diathermy Hydrotherapy ◦ Thermal & mechanical properties Electrical stimulation ◦ TENS ◦ Iontophoresis ◦ NMES ◦ ICT

Less commonly used modalities EMG Biofeedback Spinal Traction Laser therapy Vibration – whole body & local extremity

Cryotherapy Why Ice? ◦ Mild cooling often used in an effort to control:  Inflammation  Pain control  Reduce spasticity RICE ◦ Ice probably more effective than cold packs.

Cryotherapy Techniques Ice Bags or Ice Packs Ice Bags or Ice Packs

What Should Cryotherapy Be Used For? To Decrease Local Temperature To Decrease Local Metabolism To Decrease Blood Flow (Vasoconstriction) To Decrease Venous And Lymphatic Flow To Decrease Nerve Conduction Velocity To Decrease Muscle Excitability Analgesia To Decrease Local Temperature To Decrease Local Metabolism To Decrease Blood Flow (Vasoconstriction) To Decrease Venous And Lymphatic Flow To Decrease Nerve Conduction Velocity To Decrease Muscle Excitability Analgesia

Thermotherapy Techniques Hydrocollator Packs Hydrocollator Packs

Thermotherapy Techniques Whirlpools Whirlpools

Thermotherapy Techniques Paraffin Baths Paraffin Baths

short wave diathermy machine

What Should Thermotherapy Be Used For? To Increase Local Temperature To Increase Local Metabolism To Increase Blood Flow (Vasodilation) To Increase Venous And Lymphatic Drainage To Increase Elasticity of Muscles & Ligaments To Increase Nerve Conduction Velocity To Increase Muscle Excitability Analgesia To Increase Local Temperature To Increase Local Metabolism To Increase Blood Flow (Vasodilation) To Increase Venous And Lymphatic Drainage To Increase Elasticity of Muscles & Ligaments To Increase Nerve Conduction Velocity To Increase Muscle Excitability Analgesia

Electrical therapy - TENS, FES et al..

Electrical Stimulation Common uses: ◦ Pain control (TENS, interferential) ◦ Iontophoresis (Direct Current) ◦ Muscle stimulation (NMES) ◦ Tissue healing (wound care)

Electrical Stimulation Main parameters to be familiar with ◦ Frequency  Muscle – force/frequency relationship ◦ Pulse Duration  Strength Duration curve

TENS Transcutaneous Electrical Nerve Stimulation ◦ Used for Pain control 2 theories of how TENS may control pain ◦ Gate control theory – high frequency TENS ◦ Opiate-mediated control – low frequency TENS

Interferential Biophysical Characteristics Methods of delivery quadripolar: 4 electrodes, each pair to separate channel Interference at level of TREATMENT AREA “4 leaf clover” shaped field Interferential Currents

Iontophoresis Iontophoresis – use of direct current to enhance transcutaneous administration of ionizable substances. Most commonly used: ◦ Dexamethasone – anti-inflammatory agent Conditions: ◦ Epicondylitis, tendonitis, etc…

Neuromuscular electrical Stimulation (NMES) Specific Uses: ◦ Facilitation of muscle contractions ◦ NMES for restricted joint motion and contractures ◦ NMES to control spasticity

Functional Electrical Stimulation (FES) FES – the use of e-stim to produce limb movements important for ADL can be considered FES. Example: prevent shoulder subluxation during movements or to produce dorsiflexion during gait.

UltrasoundUltrasound Frequently Classified With Diathermy As A “Deep Heating” Modality Mechanical Vibration Sound Wave Trans- formed From High Frequency Electrical Energy Frequently Classified With Diathermy As A “Deep Heating” Modality Mechanical Vibration Sound Wave Trans- formed From High Frequency Electrical Energy

Mechanical Modalities

Intermittent Compression Mechanical Units That Create External Pressure Facilitates Venous And Lymphatic Reabsorbtion Of Edema Helps Decrease Pain & Increase ROM Mechanical Units That Create External Pressure Facilitates Venous And Lymphatic Reabsorbtion Of Edema Helps Decrease Pain & Increase ROM

TractionTraction

What Should Traction Be Used For? To Treat A Variety Of Cervical And Lumbar Spine Problems ◦ Creates Separation Of Vertebrae ◦ Stretches Connective Tissue ◦ Stretches Muscle ◦ Improves Blood And Lymphatic Flow ◦ Decreases Pressure On Disk To Treat A Variety Of Cervical And Lumbar Spine Problems ◦ Creates Separation Of Vertebrae ◦ Stretches Connective Tissue ◦ Stretches Muscle ◦ Improves Blood And Lymphatic Flow ◦ Decreases Pressure On Disk

Traction Techniques Manual Traction Manual Traction Traction Machines Traction Machines Manual Traction Manual Traction Traction Machines Traction Machines

Laser (light amplification for the stimulated emissions of radiation)