55

2.

Rehabilitation Medicine

T h e C a t h o l i c U n i v e r s i t y o f K o r e a

01 (Heat therapy)

(Superficial heat) 1-2 cm

(deep heat) 3.5-8 cm . 40-45.

( )

2-1 2-2 .

2-1

Superficial

Hot pack Conduction

Infrared Radiation

Whirlpool Convection

Paraffin bath Conduction

Fluidotherapy Convection

Deep

Ultrasound Conversion

Shortwave diathermy Conversion

Microwave Conversion

56

Rehabilitation Medicine

2-2

Heat therapy Cold therapy

Hemodynamic

Blood flow

Chronic inflammation

Acute inflammation

Edema & bleeding

Immediate cutaneous

vasoconstriction

Reactive vasodilatation

Acute inflammation

Neuromuscular

conduction block

axonal loss

spasticity

Muscle fatigue

Joint & connective

tissue

Tendon extensibility

Collagenase activity

Joint stiffness

Tendon extensibility

Collagenase activity

Joint siffness

General relaxation effect

General relaxation effect

1. (Superficial heat)

1)

(1) (Pain)

(2) : , , ,

(3)

(4) (Contracture)

(5) (Tightness)

2)

(1) ,

(2)

(3)

(4)

57

2.

(5)

(6) : ,

3)

(1) (H/P, Hot pack) ( 2-1)

- H/P silicon dioxide

canvas ( 74.5)

- H/P pack

H/P

(2) (I/R, Infrared) or Heat lamp ( 2-2)

- ( , ) H/P

I/R

- I/R H/P

2-1 Hot pack. A. , B. H/P

A B

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Rehabilitation Medicine

- I/R , radiation

.

(3) Heating pad

- ,

( 52)

- H/P pad

,

(4) (Hydrotherapy)

. Whirlpool(W/P) ( 2-3)

distal limb(, , ,

) ,

2-3 Whirlpool( )

2-2 I/R TENS

59

2.

37.8-40.6

. Hubbard tank

39 core temperature

. Contrast baths

reflex hyperemia

10 cycle(1-4 cold

4-6 hot)

30 , ending edema cold

(5) Fluidotherapy ( 2-4)

. cellulose particles

2-4 Fluidotherapy

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Rehabilitation Medicine

. W/P

.

(6) Paraffin bath ( 2-5)

. : ,

. 45-54

,

tolerable

.

Dipping: 7-12 dipping

20

Immersion: dipping 30

Brushing: brush

immersion

2-5 Paraffin bath. A. paraffin bath 7-8 (dipping) ( 50 .) B. dipping

A B

61

2.

4) : 5-30

2. (Deep heat)

U/S , U/S

. microwave, shortwave diathermy U/

S .

1)

- : superficial heat

(bursitis, tendinitis, adhesive capsulitis, degenerative arthritis )

, US contracture

- U/S stroking ,

, shortwave diathermy U/S

2) (U/S, Ultrasound)

- Sound waves: 17,000-20,000 Hz frequency

, acoustic vibration thermal effect(heating)

non-thermal effect

- : 0.8-3.0 MHz (frequency

penetration )

(1) Thermal effects

. Soft-tissue extensibility

.

. Muscle spasm

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Rehabilitation Medicine

(2) Non-thermal effects

. Cavitation: forced oscillation bursting turbulence

gas bubbles

. Acoustic streaming(media movement):

asymmetric pressure compressible material medium

unidirectional movement shear forces

, metabolic processes

. Standing waves: stationary pressure

3) (Shortwave diathermy; SWD)

- Radiowaves: 27.12 Hz frequency

- Applicator

(1) Induction method: cable drum applicator coiled

magnetic field water-rich tissues(, )

(2) Conduction method: capacitive applicators , electrical

field oscillation water-poor tissues(, , )

4) (Microwave diathermy)

- Microwaves: 915 MHz(33 cm wavelength), 2456 MHz(12 cm)

- Frequency penetration

-

- U/S SWD

- U/S SWD ,

63

2.

5) ( 2-3)

(1)

(2) U/S cavitation intense heating , ,

, laminectomy pacemaker

focal heating

(3) Diathermy pacemaker

(4) deep heat

(5) Microwave diathermy: , , fluid-filled cavities,

blisters

2-3 Deep heat precautions & contraindications

UltrasoundElectromagnetic agents

(shortwave & microwave)

General heat precautions

Near brain, eyes, reproductive organs /

fluid-filled cavities

Gravid or menstruating uterus

Near pacemakers, laminectomy sites,

metal

Malignancy

Skeletal immaturity

Arthroplasties

Near hear t, cervical gangl ia, acute

hemorrhage, ischemic area

General heat precautions

Metal(jewelry, pacemakers, intrauterine

devices, surgical implants, deep brain

stimulators, small clips etc.)

Contact lenses

Gravid or menstruating uterus

Skeletal immaturity

Acute hemorrhage/injury

Near eye, gonads

Cataract protective eyewear

(microwave)

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Rehabilitation Medicine

6)

(1) U/S

. , stationary standing wave

hot spot 1-2 cm/s 25-100 cm2

circular longitudinal stroking

( 2-6)

. Standing wave cavitation non-thermal effect

U/S 3.0 W/cm2 ,

0.5-2.0 W/cm2 power 5-10

(2) Shortwave diathermy

. 20-30

. applicator

. U/S

2-6 Ultrasound . A. upper trapezius. B. low back area.

A B