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:
Ultrasound: 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.
Electrotherapy: 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.
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.
Hot and Cold Therapy: Both hot and cold therapy (hot packs, cold packs, game ready devices, coolant sprays, ice massage, whirlpool and ice baths, etc.) can be used to control pain and swelling, increase blood circulation, promote muscle relaxation, accelerate tissue healing
Pneumatic Compression Devices: These devices are inflatable garments/sleeve that fit on arms, legs, trunk and even chest. A pneumatic pump intermittently fills the garment with compressed air and is used in helping to control swelling in limbs, body parts and joints, including for the treatment of lymphedema, chronic venous insufficiency, and venous stasis.
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.
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