Therapeutic Modalities Application Flashcards

A patient with chronic plantar fasciitis is treated with low-level laser therapy (LLLT). Which mechanism best explains its therapeutic effect?

Answer: Photobiomodulation promoting cellular ATP production

LLLT works through photobiomodulation, stimulating mitochondrial activity and increasing ATP production to promote healing.

When applying phonophoresis with hydrocortisone to a patient's lateral epicondyle, which ultrasound parameter best facilitates transdermal drug delivery?

Answer: 1 MHz continuous mode at 1.0 W/cm²

1 MHz continuous ultrasound penetrates deeper and the continuous mode maximizes acoustic streaming to enhance drug penetration into deeper tissue.

A PT is using interferential current (IFC) for pain modulation in a post-operative knee patient. The beat frequency most effective for endorphin release is:

Answer: 1–10 Hz

Low beat frequencies of 1–10 Hz stimulate endogenous opioid (endorphin) release for longer-lasting pain relief.

Which condition is an absolute contraindication for applying thermotherapy (moist heat pack) locally?

Answer: Peripheral vascular disease with impaired circulation

Peripheral vascular disease impairs heat dissipation, creating a risk of thermal burns and tissue damage with local heat application.

A PT applies cryotherapy immediately after acute ankle inversion sprain. Which physiological effect is the PRIMARY goal in this phase?

Answer: Reducing secondary hypoxic injury by decreasing tissue metabolism

Cryotherapy reduces local tissue metabolism, limiting secondary hypoxic injury in cells surrounding the primary trauma zone.

During TENS application for pain relief using the conventional (high-rate) mode, which sensory response indicates correct electrode placement and intensity?

Answer: Comfortable tingling or paresthesia without muscle contraction

Conventional high-rate TENS targets large-diameter sensory fibers, producing comfortable paresthesia without motor activation.

A therapist uses fluidotherapy on a patient's hand following Dupuytren's contracture release. Which unique benefit does fluidotherapy offer over paraffin bath?

Answer: Ability to perform active exercise during treatment

Fluidotherapy allows the patient to actively move and exercise the extremity during treatment, combining heat with functional activity.

A PT plans to use iontophoresis with dexamethasone to treat a patient with carpal tunnel syndrome. Dexamethasone is negatively charged; which electrode setup is correct?

Answer: Place dexamethasone under the cathode (negative electrode)

Like charges repel; negatively charged dexamethasone is driven into tissue when placed under the cathode (negative electrode).

Which ultrasound parameter should a PT DECREASE to minimize thermal effects while still promoting tissue healing in an acute inflammatory condition?

Answer: Duty cycle

Reducing duty cycle (using pulsed mode) minimizes thermal accumulation while preserving non-thermal mechanical effects like acoustic streaming.

A patient with a cardiac pacemaker presents for shoulder rehabilitation. Which modality is SAFE to apply to the ipsilateral shoulder?

Answer: Therapeutic ultrasound

Therapeutic ultrasound does not generate electrical current and does not interfere with pacemaker function when applied away from the chest.

When treating a patient with spasticity using cryotherapy, which effect on the muscle spindle explains the temporary reduction in tone?

Answer: Decreased afferent (Ia) firing from muscle spindle due to cooling

Cooling slows the firing rate of muscle spindle afferents (Ia fibers), temporarily reducing the excitatory drive and decreasing spastic tone.

Which type of electrical stimulation parameter is MOST appropriate for preventing disuse atrophy in a patient with an immobilized limb?

Answer: Neuromuscular electrical stimulation (NMES) with sufficient intensity to elicit a visible contraction

NMES at motor-level intensity produces muscle contractions that maintain muscle bulk and prevent disuse atrophy.

A PT treating a patient with open wounds over the medial knee should avoid which modality directly over the wound?

Answer: Continuous ultrasound

Continuous ultrasound over open wounds risks thermal injury to exposed tissue and is contraindicated; pulsed may be used cautiously per clinical guidelines.

For a patient with chronic venous insufficiency and lower extremity edema, which physical agent modality is MOST appropriate to assist fluid mobilization?

Answer: Intermittent pneumatic compression (IPC)

Intermittent pneumatic compression mechanically mobilizes interstitial fluid proximally, reducing edema associated with chronic venous insufficiency.

A PT uses pulsed shortwave diathermy (PSWD) over a patient's lumbar region. Which tissue type is MOST effectively heated by the inductive coil method?

Answer: Highly hydrated tissues with high water content such as muscle

Inductive coil PSWD generates eddy currents most effectively in tissues with high water and electrolyte content, such as muscle.

Which electrode placement during TENS application over the cervical spine region is CONTRAINDICATED due to risk of adverse physiological response?

Answer: Over the anterior neck across the carotid sinus

Electrode placement over the carotid sinus can trigger a vasovagal response, causing bradycardia and hypotension.

A patient with a skin sensitivity complaint after treatment states the skin feels hot and looks red after cryotherapy. Which term describes this paradoxical hunting response?

Answer: Lewis hunting reaction

The Lewis hunting reaction is a cyclical vasoconstriction and vasodilation that prevents tissue freezing during prolonged cold application.

When using high-volt pulsed current (HVPC) for wound healing, which polarity is typically used in the proliferative phase to promote fibroblast activity?

Answer: Positive polarity

Positive polarity HVPC attracts fibroblasts and promotes collagen synthesis during the proliferative phase of wound healing.

A PT is selecting ultrasound parameters for treating a superficial trigger point at 1 cm depth in the upper trapezius. Which frequency is MOST appropriate?

Answer: 3 MHz

3 MHz ultrasound has a shallower depth of penetration (1–2 cm), making it ideal for superficial structures like trigger points near the surface.

Which modality uses high-frequency alternating current (>100,000 Hz) and produces NO neuromuscular stimulation because it is above the threshold for nerve depolarization?

Answer: Diathermy (shortwave)

Shortwave diathermy operates at frequencies (27.12 MHz) far above the neuromuscular excitation threshold, so it heats tissue without stimulating nerves or muscles.