Treatment Guidelines by Keith Khoo, PT
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- Sara Golden
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1 Treatment Guidelines by Keith Khoo, PT I suggest a complete protocol of treatment for the following indications using combination ultrasound and stimulation to treat the condition and alleviate the pain and/or inflammation too. This is extremely easy with the advent of the hands-free capability of the AutoSound ultrasound applicator. For thermal applications I also recommend an active stretch in addition to the combination ultrasound/stimulation therapy. Lateral Epicondylitis AutoSound 4 cm/sec and uni-directional toward shoulder Pain: P2-Premodulated IFC or P1 -Quad IFC Hz scan Hz scan Adhesive Capsulitis (Shoulder) AutoSound 4 cm/sec and uni-directional toward shoulder 1 MHz 100% Continuous -Increase ROM while thermal ultrasound and are running. Pain: P2-Premodulated IFC or P1 -Quad IFC Hz scan Hz scan 1
2 Low Back Strain AutoSound 4 cm/sec and uni-directional 1 MHz, 3MHz, or 1 & Chain depending on muscle depth 100% Continuous -Increase ROM while thermal ultrasound and stim are running. Pain: P2-Premodulated IFC or P1 -Quad IFC Hz scan Hz scan Plantar Fascitis AutoSound 4 cm/sec and uni-directional Pain: P2-Premodulated IFC or P1 -Quad IFC Hz scan Hz scan 2
3 Carpal Tunnel - Inflammation AutoSound 4 cm/sec and uni-directional toward shoulder Pain: P2-Premodulated IFC or P1 -Quad IFC Hz scan Hz scan Carpal Tunnel - AutoSound 4 cm/sec and uni-directional toward shoulder 1 MHz, 3MHz, or 1 & Chain depending on muscle depth 100% Pulsed -Increase ROM while thermal ultrasound and stim are running. Pain: P2-Premodulated IFC Nerve Block:P Quad IFC Use Ch 2 only Vector Vector Hz scan 0 Hz scan since using 1 ch 3
4 Ankle Tendon Strain/Sprain AutoSound 4 cm/sec and uni-directional toward knee Inflammation: P3-Hi Volt or P4-Premod IFC (-over injury, + proximal same side) Muscle pump Alternate 10/10sec 50Hz Sensory Pain: P2-Premodulated IFC P1 -Quad IFC Hz scan Hz scan Neck or Hamstring Strain/Sprain - Inflammation AutoSound 4 cm/sec and uni-directional 4
5 Neck or Hamstring Strain/Sprain - AutoSound 4 cm/sec and uni-directional 1 MHz, 3MHz, or 1 & Chain depending on muscle depth 100% Pulsed -Increase ROM while thermal ultrasound and stim are running. Pain: P2-Premodulated IFC P1 -Quad IFC Hz scan Hz scan Knee Tendinitis AutoSound 4 cm/sec and uni-directional toward hip or manual applicator Inflammation: P3-Hi Volt or P4-Premod IFC (-over injury, + proximal same side) Muscle pump Alternate 10/10sec 50Hz Sensory Pain: P2-Premodulated IFC P1 -Quad IFC Hz scan Hz scan 5
6 Stimulation Muscle Re-education P5-Russian Surge 10sec on / 50 sec off 50Hz Motor contraction stimulation level Spasm P4-Premod IFC USE ONLY 2 ELECTRODES FROM CH 1 AND PLACE THEM ON THE SPASMING MUSCLE Alternating 10sec ch1 / 10 sec ch 2 but since you are only using ch 1 you get a 10 sec on and 10 sec off to break the spasm 50Hz Motor contraction stimulation level Inflammation Muscle Pump P4-Premod IFC Alternating 10sec ch1 / 10 sec ch 2 50Hz Sensory to Motor contraction stimulation level Nerve Block P1-Quadpolar IFC - ONLY USE 2 ELECTRODES FROM CH 2-0Hz due to the fact you are only using the 2 electrodes from channel 2 (outputting the 5000Hz carrier frequency to induce a nerve block by not letting the nerve re-polarize Strong sensory stimulation level with electrodes placed close together on either side of the treatment area. P1 Pain: Large areas with the four pads surrounding the area in a criss-cross electrode placement. Acute to Chronic. P2 Pain: Small to Medium areas directly over the site. Acute to Chronic. P3 Inflammation: Place white pin (negative pole) over inflamed site, place red pin (positive pole) proximal on same side. Acute to chronic. P3 Pressure Ulcers: Place white pin (negative pole) in wound (use alligator clip and make wound electrode from saline soaked gauze), place red pin (positive pole) proximal on same side. Treat once a day for 60 minutes. P4 Inflammation: Place pads from channel 1 and channel 2 on either side of the inflamed are to provide a muscle pump. Strong sensory to motor stimulation levels. Subacute to Chronic. P4 Antagonist/Protagonist Re-education: Place pads appropriately and set intensity to contract each group alternating every 10 seconds. P5 Muscle Re-education: Large to medium muscles. Place pads for optimal contraction. Patient tolerance motor stimulation level. Rich-Mar cannot prescribe treatments. Rich-Mar only recommends the Indications for Treatment as they are spelled out in the Operator s Manual. The Treatment Protocols that are shown here represent those of a practicing PT and are used as examples of the types 6 of treatments that may be performed with this device
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