MEDREH-06 · Physical Modalities

Physical Modalities. Topics: Heat, Cold, Ultrasound, Diathermy, Electrical Stimulation, Iontophoresis, Traction, and Biofeedback. Part of the Medical Rehabilitation series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: physically interacts with and helps to break up and dissolve the hardened calcium carbonate deposits trapped inside the tendon. — Correct: The calcific tendinitis deposit is calcium hydroxyapatite (a basic calcium phosphate), not calcium carbonate. Iontophoresis and ESWT mechanisms as described are otherwise correct. (2) In the audio: absorbs acoustic energy at a rate far exceeding even the absorption of cancellous bone, — Correct: Cement is not above bone in acoustic absorption; bone absorbs the most of any tissue. The hazard is heat concentrating at the cement-bone interface, causing loosening, not cement melting. (3) In the audio: It would pass right through it and dump all of its high-energy heat far deeper into the shoulder joint space itself. — Correct: A 1 MHz beam does not pass through superficial tissue untouched; it deposits energy there too but attenuates more slowly. The depth rule stands: 3 MHz for targets 1 to 2 cm deep, 1 MHz for 5 to 8 cm. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/MEDREH-06.