Modalities: What do you find helpful?

[fozzy40]

Advertisement - Members don't see this ad

Hey gang,

I know that the literature is not really in support in one way or the other regarding modalities. Personally, I'm not a big fan of modalities in general because of it's passive nature. However,I am a big fan of "whatever works."

That being said, what modalities do you find useful?

Thanks again!

 

[Fiveoboy11]

New book coming out by Michelle Cameron, MD, PT, OCS 4th edition on Oct 26, 2012
Physical Agents in Rehab
http://www.amazon.com/Physical-Agen...d=1351127929&sr=1-4&keywords=physical+therapy


Here's my thoughts. Look forward to hearing what everyone else thinks:

LLLT (904nm, .5-1.2 J/cm2, single point laser) supposedly helpful for epicondylitis, frozen shoulder
US (20% duty cycle) helpful for fracture healing
MHP ?? helpful with extreme hypersensitivity (i.e. fibromyalgia, maybe suboccipital HA's, s/p MVA)
CP ?? helpful with localized edema
E-stim ?? worthless
NMES quad strengthening associated with s/p ACL repair, or PF pain/maltracking
Leukotape may help with acute ankle sprains, post tib dysfunction, achilles tendonitis, patellar tracking
Augmented soft tissue tools - graston, ASTYM, edge, bla bla - tendonitis, scar tissue

 

[jesspt]

New book coming out by Michelle Cameron, MD, PT, OCS 4th edition on Oct 26, 2012
Physical Agents in Rehab
http://www.amazon.com/Physical-Agen...d=1351127929&sr=1-4&keywords=physical+therapy


Here's my thoughts. Look forward to hearing what everyone else thinks:

LLLT (904nm, .5-1.2 J/cm2, single point laser) supposedly helpful for epicondylitis, frozen shoulder
US (20% duty cycle) helpful for fracture healing
MHP ?? helpful with extreme hypersensitivity (i.e. fibromyalgia, maybe suboccipital HA's, s/p MVA)
CP ?? helpful with localized edema
E-stim ?? worthless
NMES quad strengthening associated with s/p ACL repair, or PF pain/maltracking
Leukotape may help with acute ankle sprains, post tib dysfunction, achilles tendonitis, patellar tracking
Augmented soft tissue tools - graston, ASTYM, edge, bla bla - tendonitis, scar tissue

I would agree with most of what Five says above, but can't say that I've used a laser at all. Also, I have probably only plugged in my US or estim machine two to three times in the last year.

Most of the above need to be used with some caution in patients with fear avoidance beliefs and those who have already adopted passive coping strategies, as they will tend to further encourage these characteristics.

Additionally, we do have some data about what happens to patients with adhesive capsultis when we emphasize the use of passive modalities in their treatment. As you might emagine, the results are not good:

http://ptjournal.apta.org/content/89/5/419.full

 

[PTisfun]

E-stim ?? worthless

There is some good evidence about the use of e stim as an adjunct in wound healing. There is a cochrane review on it so I think worthless is not an accurate picture. The cochrane review for ultrasound is pretty much null but hv
E stim = good results.