Tissue Repair &
Electrotherapeutic Agents
Causes of Inflammation
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Soft tissue trauma
Fractures
Autoimmune diseases
Microbial agents
Chemical agents
Thermal agents
Irradiation
Foreign bodies
Inflammation & Repair
consists of 4 phases:
1.
2.
Initial injury phase (bleeding, clot,…)
Inflammatory response phase (prepares
wound for healing)
3. Fibroblastic repair phase, proliferation
(rebuilds damaged structures & strengthen
the wound)
4. Maturation phase, remodeling (modifies
the scar tissue into its nature form)
Initial Injury Phase
Destruction of tissue (injury of cells)
bleeding
Inflammatory Phase
Signs of inflammation
Fibroblastic – Repair
(proliferative) Phase
First few hours after injury 4 to 6
weeks
Reconstruct (fibroblasts- endothelial
cells – macrophages)
Resurfacing
Strength of wound
Processes Occur in The
Proliferative Phase
Epithelization
Collagen production fibroblasts
Wound contracture
myofibroblasts. Contract pulling the
ends of wound (scar)
Neovascularization
Maturation (Remodeling)
Phase
Takes months or years
Change in size, form & strength of scar
tissue
Fibroblasts, macrophages, myofibroblasts,
capillaries and water content of tissue
The goal is restoration of prior function of
injured tissue
Factors Affecting Rate of
Maturation & Scar Characteristics
are:
Fiber orientation
Balance of collagen synthesis and lysis
Factors That Impede
Healing
Extent of injury
Edema
Hemorrhage
Bad vascular supply
Separation of tissue
Muscle spasm
Atrophy
Factors That Impede
Healing
Corticosteroids
Keloids & hypertrophic scar
Infection
Humidity climate & oxygen tension
Health, age & nutrition
Injury Management
Cryotherapy
RICE (rest, ice, compression &
elevation)
The Role of Progressive Controlled
Mobility in The Maturation Phase
Wolff’s Law: states that both bone &
soft tissue will respond to the physical
demands placed on them, causing
them to remodel along the line of
tensile force.
Immobilization
Control mobilization,
revascularization, muscle
regeneration & reorientation of
muscle fibers
Active strengthening exercises in the
remodeling phase
Modality not combined with antiinflammatory medication during
initial acute & inflammatory phases
Applied Electrical Charges
The effect on the body depend on:
Intensity
Nature of resulting current
Chemical changes (direct current)
Stimulation of excitable tissues (
stimulating current)
High currents significant heating
(diathermy)
Therapeutic modalities can restore
normal cell membrane potential and
leads to decreasing inflammation,
decreasing edema and increasing
healing.
Good Luck
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