What are the therapeutic Modalities for Rehabilitation?


What are the therapeutic Modalities for Rehabilitation?

Literally, Rehabilitation may mean to restore back to use; or bring back to use’. Rehabilitation process and period is very crucial and fragile, needs to be technically and professionally handle so as to achieve the dream of coming back to top form level.

The period is a period of proper and complete total healing and restoration. These therapeutic modalities must carefully be followed. They include:-

(a) Cryotherapy

(b) Thermotherapy

(c) Mechanical Electrical

(d) Pharmacological Agents

All these therapeutic Modalities are capable of helping the process of come back when used appropriately. Only two of these modalities shall be treated in this work.

In this post, you will be able to define and correctly explain each of the key terms, discuss the purpose of Therapeutic Modalities, List the different types of Modalities and explain how some are used and discuss several safety considerations involved with the use of Therapeutic Modalities.


Cryotherapy Modalities

What are the therapeutic Modalities for Rehabilitation?

This method of therapy includes several others such as; ice massage, cold water immersion, ice packs, and vapor-coolant sprays. Due to the cold that is used in cryotherapy, the athlete or patient may feel uncomfortable when it is first applied.

As with all procedure, you should explain the procedure to the patient in advance so as he or she knows what to expect. In the application of cryotherapy, the longer the cold treatment, the deeper or depth the cold penetration to the underlining tissues i.e treatment involving bigger muscles, the. Cooling the body tissue can decrease blood flow, reducing muscle Spasms, Pain, and Edema.

These therapeutic effects are achieved when cold is applied tissue to constrict. Cooling an area for less than 15 mins does not reach a therapeutic depth or level, and increase blood flow instead.

After 20 mins of cryotherapy, the body defends itself in much the vessels to dilate. When cryotherapy, the body defends itself in much the vessels to dilate.

When cryotherapy is used at a therapeutic depth, the person will experience three phases of sensation: 1. A cold sensation lasting 0-3 mins

2. Mild burning and acting 2-7 mins

3. Relative numbness lasting 5-12 mins

Rehabilitation process and period is very crucial, and fragile that needs to be technically or professionally handled, to avoid a falling back to same or even a more divesting condition. The period of come back of an injured athlete is a period of joy and apprehension which requires some therapeutic modalities or processes that will manipulate circulation (blood flow) blood in the treatment of muscles and joints.

The purpose is to improve or restore the athlete’s range of motion, physical agility on ability to engage in daily activities and athletic endeavor at his or her optimal performance level. Several approaches are usedcondition and the muscles and joints.

It is important to understand how such therapy can be helpful to the athletes and most importantly the safety can be classified into five general types, thus;

i) Cryoptheraphy

ii) Thermotheraphy

iii) Electricaltheraphy

iv) Mechanical modalities

v) Pharmacologic agents, depending on the mode of stimulation.


Injury Rehabilitation

Rehabilitation of sports injuries start immediately in the form of First aid, the therapy is only to determine by the type, extend, or area of injury involve. For proper understanding of the modalities approaches used in rehabilitating sports injuries, the modalities can be grouped into

(1) Exercise (comprising of passive and active exercises)

(2) Pharmacologic Agents, depending on the mode of stimulation.

Injuries such as contused wound, (strains and sprains) increase blood flow to the area tissues involve resulting in inflammation and edema.

Symptoms of inflamed tissues include, pain, heat and redness. Due to this local trauma, the vessels does not carry the tissues oxygen to the tissues, and it may cause muscle spasms and increased edema. The muscle spasm thencausesadditional pain which can increase the spasm and so on.

This syndrome is called the ‘Muscle Spasms/Pain Cycle’ and levels to decreased mobility. Modalitiesare used to stop, slow, or otherwise interrupt the Muscle Spasms/Pain Cycle.

For example, method of cryotherapy– can be applied to the inflamed area. The cold (ice) will course construction in the blood vessels, decreasing local inflammation and edema, as well as stopping or slowing the muscle spasm/pain cycle.

As helpful as this may be, it is important to know that a wrongful use or misapplication of a modality (method) may only aggravate a condition rather than providing relief.


Guidelines for Cryotherapy

1. Except for ice massage, all cold modalities required the use of a barrier, such as a towel, to prevent the skin from frostbite. This applies to both ice and reusable packs, which reach temperature below freezing.

2. Never applied any form of cold on an open wound without a protective covering.

3. Never apply and form of old to anesthetized skin.

4. Except for vapo-codant sprays, do not apply cryotherapy to patients with decreased circulation, diabetes, or Cardiac conditions.

5. Monitor the patient for signs of cold allergy or Raynaud ’s phenomenon, a condition in which the arteries and arterioles of an extremity constrict excessively. 6. To avoid further injuries to the tissues always monitor the time for which cryotherapy is applied, application should not exceed 30mins.


Guidelines for Applying Ice Pack

1. Fill a plastic bag with enough crushed ice to model around the injured area. Or obtain a result able ice pack from the freezer.

2. Explain the procedural effect to the patient

3. Expose the area to be trended draping the patience for modesty as appropriate

4. Wet an elastic wrap or towel and place it between the ice and the patient’s skin. Especially when using a revisable or chemical ice pack to prevent a burning effect.

5. Leave the ice in place for 15-20mins, checking with the patient periodically for signs of undue discomfort or cold allergy. 6. Leave treatment area clean and dry when you are done. Wipe up any water drops from the floor to prevent others from slipping.


Guidelines to Ice Massage

1. Prepare the ice by freezing a disposable cup ¾ full of water, forming a cylinder of ice. Massage the ice to the area to be treated. Use materials that will prevent your fingers to the cooling effect from the ice. 2. Expose the area to be treated, draping the patient for modesty as appropriate. Use towel to sock the water drops from the ice.

3. Explain the procedure to the patient.

4. Slowly massage the ice over the injured area in overlapping stokes, taking care not to cause the patient undue discomfort by the pressure of the strokes. Remove more of the Styrofoam or paper from the ice container as the ice melt.

5. After 7 to 10mins of treatment dry the patients skin and assist him or her from the treatment table. 6. Leave the treatment area clean and dry when you are done. Wipe up any water drops from the floor to prevent others from slipping.


Other cryotherapy modalities include:

i. The use of vapo-coolant spray

ii. Ice water immersion

iii. Whirlpool baths

iv. Contrast baths

v. Thermotherapy e.g moist heat packs/hydro-collator

 vi. Fluidotherapy

vii. Paraffin bath


Electrical Modalities

This modalities uses electricity to influence healing by stimulating the body tissues. Like the other therapeutic modalities, electrical modalities are used to speed up the healing of tissues. Because electrical modalities penetrate deeper into the tissues than other modalities, they are among the most effective in terms of decreasing healing time.

In general, low voltage stimulation is used to help control pain and high voltage stimulation is used to increase blood flow. General instructions for the electrical modalities follow, but should not be interested as sufficient instruction for therapeutic use in a professional environment.


Guidelines for electrical modalities

Administration of electrical modalities requires special training beyond the scope of these instructions. 

Furthermore, procedures will vary according to the modality and equipment used.

The following guidelines will be helpful.

1. Follow the physician or therapists orders for all electrical modalities

2. Make sure the equipment is in proper working condition, is plugged in, and is powered through a circuit served by a ground fault interrupter.

3. Explain the procedure to the patient.

4. Expose the area to be treated

5. Cleanse the treatment area with soap and water or alcohol. Then, dry it thoroughly. (cleaning the patients skin of dirt and oils will ensure proper adhension of the electoe pads).

6. Place electrode pads according to the manufacturer’s instructions

7. Avoid prolonged point contact when using ultrasound.

8. Follow the manufacturer’s instructions for use of all equipment. Improper use may cause burns or fire.

9. Turn the treatment channel(s) off before carefully removing the adhesive electrodes from the patients skin.

10. Leave the treatment area cleans when you are done

11. To prevent infection and ensure safe use, follow the manufacturer’s instructions for cleaning and maintaining the unit.

12. Never use an electrical modality on an open wound.

13. Do not use electrical modalities on a patient with a pacemaker without approval from a physician, as this may interfere with the pace of the heart set by the pace maker.

14. Avoid high fluid area of the body when using electrical modalities. The electrical current may be intertied by high concentration of fluid, causing burns.

15. Avoid using electrical modalities over the carotid arteries as this could change the patient’s blood pressure and cause him or her to faint.

16. Electrical modalities must never be used on the trunk of a pregnant patient. Their use on the extremities is permitted upon approval by the physician.

17. Stop the treatment if the procedure increases the patient’s pain.


The following are some electrical modalities used in the therapeutic modalities:

i. Ultrasound therapy

ii. Electrical muscle stimulation (EMS)

iii. Galvanic stimulation

iv. Interferential stimulation

v. Lontophoresiss

vi. Transcutaneous electrical nerve stimulation (TENS)

vii. Diathermy


Mechanical Modalities

This include; intermittent compression, Fraction and massage theropy, assist in healing by exerting pressure to the soft tissues, increasing circulation and/or distraction (pulling) bony structures. 

This pressure can be applied manually or with device. Joint mobilization and my of asocial release, performed by seaports, chiropractors, physical therapist and certified athletic trainers are also mechanical modalities, but are beyond the scope of this text due to the amount of training that is required to use them. 

General instructions for the mechanical modalities follow, but should not be interpreted as sufficient instruction for therapeutic use in a professional environment.


Guidelines for Mechanical Modalities

Guidelines for electrical modalities, administration of mechanical modalities requires special training beyond the scope of this module write up.

However, some general guidelines are as follow;

1. Follow the manufacturer’s instructions, for use of all equipment.

2. Frequent circulation cheeks of extremities are important when applying traction

3. Stop the treatment if the procedure increases the patient pain.


Massage Therapy

Is the systematic manipulation methodical pressure, friction and kneading of the soft body tissues. It is used to stimulate muscles, decrease muscle spasms, increase circulation, decrease edema and promote relaxation.

There are five types of massage therapy:

i. Effleurage

ii. Petrissage

iii. Deep Friction

iv. Tapotement

v. Vibration


Lubricants, such as oil, lanolin, powder, analgesic balms, or special lotions, may be used with any of these forms of message to decrease the skin friction.

Effleurage: Consists of strokes that glide over the skin without attempting to move the deep muscle group. This form of massage is done with either the palms or the fingers. Usually effleurage is used to either begin or end a massage treatment; it may also be used to direct muscles tightness.

Petrissage: Is done by kneading the soft tissues between the thumb and fore finger or with the palm of the hand. The rolling and twisting motion of the tissue stimulates fluid drainage. Fluid drainage is beneficial to the patient because it remove cellular waste from the body tissues.

Deep Friction: This massage is performed primarily on joints and areas with little soft tissue. The thumbs and fingers are rotated on the skin in a circular pattern, applying enough pressure to contract the underlying tissue. An alternative to the circular pattern of deep friction message is transverse friction. In transverse friction massage, the strokes are applied in a transverse pattern over a tendon. The effects of friction massage are to increase circulation and decrease scar tissue.

Tapotement: Or percussion involves “beating” the hands or fingers upon the skin. This form of massage can be done using clenched hands, the palms of the hand, the ulnar borders of the palms, or the fingertips. Care is taken to avoid inducing pain by contacting the person too harshly.

Vibration: Is a form of massage that makes use of a vibrating machine or quick motions of the fingers to produce therapecetic benefits. The benefits of vibration are increased circulation and lymphatic drainage.

Vibration massage also provides a mild stretch of the superficial tissues, which is beneficial because it increases the elasticity of those tissues. Massage has value to self and to others levels and this might require more professional training and service.


Hints on Massage Therapy

1. Expose the area to be massaged and drape the patient to provide warmth and maintain professional standards of modesty, making sure you have good access to the area. (never massage an infected area or over a recent injury).

2. Position the patients as comfortable as possible

3. Apply a light lubricant to the body area

4. Begin with light massage strokes (effleurage). Deeper, heavier massage may follow, depending upon the clients comfort level and therapeutic needs. By watering the patients face and/or body movements you can monitor the clients tolerance to different levels of massage pressure. Avoid harsh massage strokes that cause undue discomfort to the patient.

5. Be sure to keep one hand on the patient’s body at all times. This will make the patient to know where you are in relation to his or her body and helps avoid startling the patient with an unexpected touch.

6. When reduction of edema is the goal, strokes from below the injury site toward the heart.

7. Maintain a steady rhythm during the massage and end the session with light massage strokes.

The last step in giving the treatment is to remove the massage lubricant. This is done with a clean, dry towel.

8. Leave the treatment area clean when you are done. Discard used towels in the place designated by the facility.


Other mechanical modalities include:

· Intermittent compression

· Traction

The last modalities in rehabilitating an injured athlete is the use of ‘pharmacologic agents’. This should be prescribed by a qualified medical professional. They constitute an important aspect of therapy that must not be over look. A variety of drugs are used in the treatment of pain, edema, inflammation and muscle spasms resulting from injuries.

Drugs commonly used to control these symptoms includes; anesthetics, analgesics, no steroidal anti-inflammatory drugs (NSAIDs), cox-2 inhibitors, corticosteroids, and muscles relaxants. These drugs are best used in conjunction with the other therapeutic modalities earlier discussed or mentioned.

Muscle relaxants: such as cyclobenza prime metaxalone, carisoprodol and dantrolene relieve muscles spasms resulting from injury or inflammation.


Conclusion on the therapeutic Modalities for Rehabilitation

It is assumed that you have learnt the contents in this post. Therefore, therapeutic Modalities are methods of applying physical agents to create an optimal environment for healing and reduce an individual’s pain and discomfort following of injury or recognition of certain disease processes.

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