Administering Physical Agents

Question 1

Pre Treatment communication - how should I address my patient?

Answer 1

1. introduce yourself and sit at eye level during interview -should occur at the start of the session
2. explain rationale for decision-making regarding treatment choice
3. Ask regarding precautions and contraindications
4. explain what you are going to do before you do it
5. let patient know what to expect during treatment (what they will feel/need to do, provide positive patient expectations)
6. Ask if patient has any questions and ask for permission to move ahead with the intervention

Question 2

How do you decide which pre-test measures to use?

Answer 2

this is determined by subjective and objective exam and needs to be something meaningful to the patient

Question 3

When should pretest measures be done?

Answer 3

the pretest measures should be done immediately before modality usage so that you don’t cloud the information gathered regarding effectiveness of this intervention

Question 4

Something meaningful to the patient…. what does this include?

Answer 4

• movements that are painful or limited
• swelling
• ROM
• strength

When assessing this information try to objectify as much as possible. Ex. when assessing ROM also obtain NPRS

Question 5

pre-treatment assessment, What to look for?

Answer 5

Visually
-color, size (swelling, atrophy)
-look for any other abnormalities to use as baseline assessment
Palpate
-use back of hand for temperature assessment
-palpate texture, swelling, muscle tone, etc
-does patient have intact sensation (light touch, sharp, temperature discrimination) Start here and get more specifics as needed - make sure hot/cold discrimination exists before using cryo/thermo therapy

test treatment area and compare with uninvolved body region

Question 6

Administering treatment in a safe environment includes

Answer 6

body mechanics/positioning of patient and staff
safe use of modalities
clean skin/area that you are treating

Question 7

Appropriate patient positioning depends on:

Answer 7

• patient diagnosis and comfortable position (think about entire patient)
• is patient’s position of comfort potentially going to hinder effectiveness of treatment
• modality being used

Question 8

What to consider to correctly program/set-up physical agent…

Answer 8

• appropriate layers for heat/ice
• appropriate electrode size and placement for electrical stimulation
• know how long to administer treatment
• identify appropriate vs inappropriate response to treatment

Question 9

What to do at the end of a session

Answer 9

1. shut off and remove modality
2. reassess patient - ask, visualize, palpate, test-treat-RETEST
3. Provide other interventions
4. Educate - post-treatment expectations, HEP