Therapeutic modalities are a wide range of therapeutic devices and interventions used by physical therapists, occupational therapists, chiropractors, and certain medical personnel to treat pain, relax muscles, prevent muscle wasting (atrophy) due to disuse or immobilization, stimulate muscle fibers to re-educate muscles post-surgery, generate heat in muscles and other soft tissues, increase blood flow and oxygen delivery to targeted tissues, facilitate musculoskeletal healing, restore function and range of motion to joints and tissues, facilitate wound healing, and deliver certain medications.
Patients undergoing musculoskeletal injury rehabilitation generally progress through three phases of rehabilitation:
Phase I: Known as the Acute or Maximum Protection phase, where the primary goals of rehabilitation are to control pain and inflammation and minimize the negative effects of immobilization.
Phase II: Known as the Subacute or Moderate Protection phase, where the primary goals of rehabilitation are to restore soft tissue and joint mobility and develop neuromuscular control.
Phase III: Known as the Chronic or Minimum Protection phase, where the primary goals of rehabilitation are to achieve full soft tissue and joint mobility, increase muscle strength, and progress neuromuscular control.
The various therapeutic modalities are primarily used in rehabilitation phase I to control pain, prevent muscle atrophy, increase blood flow to injured tissues, and prevent a loss of range of motion (ROM) of affected joints. To a lesser degree, therapeutic modalities are also used in rehabilitation phase II to restore soft tissue and joint mobility and develop neuromuscular control.
Therapeutic Modality Devices
There are various therapeutic modality devices used to treat patients with different musculoskeletal injuries/conditions. These include:
Combined Ultrasound/E-stim Therapy: These combined therapy modalities of ultrasound and electrical stimulation work to maximize the benefits of each in treating patients suffering from pain, muscle spasm, edema, loss of range of motion and muscle atrophy.
Continuous Passive Motion (CPM) Devices: As the name implies, motorized CPM devices are designed to passively (no patient effort involved) move a joint back and forth (speed of movement and degrees of motion) through a range of motion. This is intended to maintain range of motion, reduce scar tissue formation, and modulate pain.
Dry Needling: The application of tiny needles being inserted through the skin and into tense and aching muscles and connective tissues to treat musculoskeletal pain.
Electrotherapy Devices (NMES/EMS): Electrotherapy is used in physical therapy to help relax muscle spasms, prevent or minimize muscle atrophy, increase local blood circulation, muscle rehabilitation and re-education toward reducing chronic pain, increasing range of motion and muscular strength, administration of certain medications, and application of light therapy with lasers toward the synthesizing of enzymes and other materials specific the tissue repair process.
Ice Compression Therapy: This modality combines ice or cold therapy with compression therapy to (the “I” and “C” elements in RICE) facilitate recovery from injuries involving the upper and lower extremities and their joints as well as being used for post-surgical therapeutic rehabilitation.
Iontophoresis: The use of electrical stimulation to deliver medication into your body through the skin (transdermal).
Laser Therapy: The application of a therapeutic dose of light to reduce inflammation and promote cellular and tissue healing.
Shortwave Diathermy: This modality converts high-frequency electromagnetic energy into heat to warm deep tissues to promote increased blood flow and healing to damaged tissues.
TENS Unit: The application of small electrical currents into the body to reduce the transmission of pain signals to the CNS as well as stimulating the release of endorphins, both of which serve to reduce pain.
Ultrasound (US): Ultrasound therapy involves the conversion of power into acoustic power to cause mechanical vibrations which produce thermal (heat) and non-thermal effects. Thermal effects warm the tissues and increase blood flow to facilitate healing as well as pain relief. Non-thermal effects include the breaking down of scar and mechanical stimuli to promote healing rates in the treatment of different musculoskeletal problems like sprains, strains, bursitis, and chronic repetitive motion conditions.
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