Therapeutic modalities in rehabilitation

Modalities are best used by the sports therapist as adjuncts to other forms of

therapeutic exercise. Decisions on how a particular modality may best be used should be based on both theoretical knowledge and practical experience.

Electrical stimulating currents may be used to stimulate sensory nerves to modulate pain, stimulate motor nerves to elicit a muscle contraction, introduce chemical ions into superficial tissues for medicinal purposes, and create an electrical field in the tissues to stimulate or alter the healing process.

The physiological response of the biological tissues to electrical stimulating currents is to a great extent determined by the treatment parameters of the current selected by the sports therapist.

Shortwave and microwave diathermy units use extremely high frequency electrical currents to produce a tissue temperature increase in the deeper tissues.

Ultrasound is vibrational acoustic energy that causes a tissue temperature increase in addition to other physiological effects that aid healing. Ultrasound has a number of advantages over diathermy, including deeper penetration and more portable and less expensive equipment.

The effects of thermotherapy and cryotherapy are primarily superficial. These modalities are perhaps most effectively used to produce analgesia. They also have an indirect effect on circulation in the deeper tissues.

Low-powered lasers are the newest modality used in sports-medicine settings, primarily to promote wound healing and also pain modulation through stimulation of acupuncture and trigger points.

Modality use in the initial acute injury phase should be directed toward one goal, that being to reduce the amount of swelling that occurs. The less the amount of initial swelling, the less time will be required for rehabilitation. During the inflammatory-response stage of healing, modalities should be used to reduce pain and limit the amount of swelling. The injured part should be rested to allow the healing process to work.

During the fibroblastic-repair phase, thermo-therapy may be used to increase blood flow to the injured area. Also during this time, strengthening and range-of-motion exercises should begin.

The maturation-remodeling phase is a long-term process during which the athlete returns to activity. Deep-heating modalities that increase blood flow and assist in the breakdown and removal of the by-products of the healing process should be used. The quantity and intensity of therapeutic exercise should be progressively increased during this phase of healing.

2.1. Listen to the text of the oral topic “Therapeutic Modalities in Rehabilitation”.

2.2. Read and translate the text.

2.3. Answer the questions to the text.

1. Modalities are best used as adjuncts to other forms of therapeutic exercise,

aren’t they? 2. What should decisions on how a modality may be used be based on? 3. When are electrical stimulating currents used? 4. For what purpose do the sports therapists use shortwave and microwave diathermy units? 5. Why does ultrasound have advantages over diathermy? 6. Which modalities are used to produce analgesia? 7. What benefits do low-powered lasers do for wound healing? 8. What is the goal of modality use in the initial acute injury phase? 9. What targets is modality use directed toward during the fibroblastic-repair phase? 10. How can modality use facilitate the healing process at the maturation-remodelling phase?

2.4. Find English equivalents for the following.

физиотерапия; дополнение/приложение; решение; отдельный/конкретный;

боль; электрические стимулирующие токи; афферентные нервы; эфферентные нервы; вызывать/добиваться; мышечное сокращение; вводить; химические ионы; поверхностный; электрическое поле; изменять/чередовать; физиологическая реакция; в значительной степени; определять; параметры лечения; выбранный; коротковолновый; микроволновый; диатермия; электротоки очень высокой частоты; ультразвук; вибрирующая акустическая энергия; вызывать; в дополнение к; которые помогают излечению; преимущество; над; включая; глубокое проникновение; портативный; дорогой; криотерапия; с целью обезболивания; косвенный эффект; кровообращение; лазеры низкой мощности; сфера спортивной медицины; способствовать заживлению ран; иглоукалывание; бистабильный мультивибратор; начальная стадия тяжелой травмы; направлено на одну цель; величина опухоли; кровоток; длительный/ долгосрочный процесс; расщепление и удаление (вывод); побочный продукт; количество; интенсивность; постепенно

2.5. Supply the gaps with articles if necessary.

1. Modality use in … initial treatment phase should be directed toward limiting … amount of swelling and reducing pain that occurs acutely. 2. … acute phase is marked by swelling, pain when touched, and pain on both active and passive motion. 3. In general, … less initial swelling, the less … time required for rehabilitation. 4. Traditionally, … modality of choice has been and still is ice.

2.6. Open the brackets and use the verb in an appropriate tense form.

1. Cryotherapy (produce) vasoconstriction, at least superficially and perhaps indirectly in the deeper tissues, and thus (limit) the bleeding that always (occur) with injury. 2. Ice bags, cold packs, and ice massage all (may, use) effectively. 3. Cold baths (should, avoid) because the foot (place) in the gravity-dependent position. 4. Cold whirlpools also (place) the foot in the gravity-dependent position and (produce) a massaging action that is likely to retard clotting. 5. The importance of cryotherapy techniques for reducing acute swelling probably (exaggerate). 6. Cryotherapy (be) perhaps best used for producing analgesia, which most likely (result) from stimulation of sensory cutaneous nerves that, via the gating mechanism, (block) or (reduce) pain.

2.7. Fill in the gaps with prepositions if necessary.

1. Compression is perhaps the most critical element … controlling swelling initially. 2. An intermittent compression device may be used to provide even pressure … an injured extremity. 3. The pressurized sleeve mechanically reduces the amount … space available … swelling to accumulate. 4. Units that com­bine both compression and cold are extremely useful … this phase. 5. Regardless of the specific techniques selected, cold and compression should always be combined … elevation to avoid any additional pooling … blood … the injured area from the effects … gravity.

2.8. Ask questions to the words in italic.

1. Electrical stimulating currents may also be used in the initial phase for pain reduction. 2. Parameters should be adjusted to maximally stimulate sensory cutaneous nerve fibres, again to take advantage of the gate control mechanism of pain modulation. 3. Intensities that produce muscle contraction should be avoided because they may increase clotting time. 4. The low-power laser has also been demonstrated to be effective in pain modulation through the stimulation of trigger points and may be used acutely. 5. The injured part should be rested and protected for at least the first 48 to 72 hours to allow the inflammatory phase of the healing process to do what it is supposed to.

2.9. Read, translate a text below. Have it for dictation.