Electrophysiological Agents in Physical Therapy
An Evidence Based Approach
October 23 and 24, 2010
Thunder Bay, Ontario, Canada
What does the current literature tell us about the use of various
therapeutic modalities?
What is the most up to date information on cryotherapy,
thermotherapy, ultrasound, TENS, interferential current,
neuromuscular electrical stimulation and laser?
Are you using the appropriate dosage and parameters to get the
desired results?
Are you not using a modality that is in fact supported by the
evidence?
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Dr. Ethne Nussbaum
Ethne Nussbaum, Ph.D, M.Ed, BScPT is an Associate Professor in
the Department of Physical Therapy at the University of Toronto,
Ontario, Canada where she instructs the courses in electrophysical
agents. She is also a member of the Graduate Department of
Rehabilitation Sciences, University of Toronto, holds a crossappointment to Toronto Rehab in research and is a faculty member
within the Masters of Clinical Science degree in the wound healing
field at the University of Western Ontario She has a clinical
appointment at Mount Sinai Hospital in the Department of
Rehabilitation where her focus is on patients with chronic wounds.
She is a member of the Board of Directors of the International
Society of Electrophysical Agents (ISEPA).
The focus of her research is soft tissue repair, in particular on the
effects of ultrasound, laser light and ultraviolet radiation and her
work is published in numerous peer-reviewed journals. She is a
regular guest speaker on the evidence base of electrophysical
agents. She has received research funding from the Ontario
Neurotrauma Foundation, The Canadian Institutes of Health
Research, the Bickell Foundation, the Physiotherapy Foundation of
Canada and the Faculty of Medicine, University of Toronto. She has
received awards from the University of Toronto for excellence in
teaching continuing education, from the Canadian Physiotherapy
Association for excellence in research and from Mount Sinai
Hospital for staff excellence.
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Date and Fee:
October 23 and 24, 2010
$375.00 per person. Limited enrolment.
Deadline:
Registration must be received by October 8,
2010
Cancellation:
A fee of $75.00 will be charged for a
cancellation received before October 15, 2010.
After this date, no refund can be made unless a
replacement is found.
Location:
Victoriaville Physiotherapy Centre
611 Victoria Avenue East
Thunder Bay, Ontario, Canada
P7C 1B1
Contact:
Paolo Sanzo
807-623-1322
activepotentialrehab@tbaytel.net
Name:
_________________________________
Address:
_________________________________
Telephone:
Home:
_________________________________
Work:
_________________________________
Fax:
_________________________________
Email:
_________________________________
Make cheque payable to Active Potential Rehabilitation Services
Mail to:
Active Potential Rehabilitation Services
3342 Oliver Road
Thunder Bay, Ontario, Canada
P7G 1S9
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Topics covered and course breakdown include:
Cryotherapy
Laser therapy
Ultrasound to
promote tissue
repair
Heating tissue
Heating
continued
Electrical
current
TENS / IFC
NMES
NMES Demo
Wound
management
Content
Beneficial effects of applying cold to prevent development of swelling;
possible adverse effects of cold on existing swelling.
Effects of cold on sensation, proprioception, tissue stiffness and strength.
The importance of timing of cryotherapy in a treatment program.
Using ice to reduce pain without adverse effect on tissue healing and
extensibility.
Questions/discussion
Brief review of the main characteristics – wavelength, pulse repetition
rate, power density, energy density, coherence. Which characteristics
are truly critical to treatment outcome?
Efficacy of laser in the treatment of chronic wounds, soft tissue injury,
chronic inflammation, fibrosis and pain with clinical guidelines
Questions/discussion
The evidence for using US to treat ligament, tendon, nerve, and bone
injury & for chronic wounds.
Effectiveness of ultrasound delivered under water.
How long, how often and when to stop.
Precautions, contraindications and myths.
Questions/discussion
Critical temperature for increasing tissue extensibility. Effectiveness of
US as a heating agent
US vs. SWD vs. hot-pack for heating tissue.
The risk attached to using more than one heat treatment.
Sequence of a heating agent in a treatment session.
US Demo.
Introduction to electrical current (all types).
Precautions and Safety
The critical elements of electrical current in the management of pain –
pulse characteristics, amplitude, electrode placement, treatment
duration.
A new understanding of the mechanism of A-TENS.
TENS in long term pain management – looking at a training period and
patient education
IFC – an unusual waveform but essentially another form of TENS!
A clover-leaf pattern – it’s just an IFC myth!
Affects of IFC and TENS on circulation, swelling, bone healing and
stiffness. Does the evidence support common practice?
Questions/discussion
Some basics - how many contractions, what rate, what rest period,
what muscle length, what electrode size, how often.
Russian current – is it another gimmick or a must have modality for
strengthening muscle in professional and recreational athletes.
Re-education and endurance training in the neurological population.
Questions/discussion
Re-education of muscle patterning – shoulder complex...
Quadriceps strengthening comparing portable & Russian stim.
Allowing for demo on a model but longer if participants want to try it
out on themselves.
I put this in because the new practice authorities for PTs will soon be
enacted. The College of PT is at this moment drafting a set of
competencies that PTs will need to demonstrate in order to practice in
the area of wounds.
The course content could cover pathophysiology of wounds (arterial,
venous, pressure ulcers), assessment of risk, assessment/measurement
of wounds, cleaning/applying dressings to wounds, techniques of
treatment using electrical stim & UV radiation.
Time
45 min
90 min
60 min
45 min
60 min
60 min
100 min
90 min
45-60 min
120 min
A representative from Remington Medical shall provide some units
for course participants to utilize during the course as well.