Intro Flashcards
Procedural Interventions
- Therapeutic exercise
- Functional Training-home & work
- Manual therapy techniques
- prescription, application, fabrication of assistive devices
- Airway clearance techniques
- integumentary repair/protection
- electrotherapeutic modalities
- Physical agents and mechanical modalities
Electrotherapeutic modalities
Broad group of agents that use electricity
-biofeedback
Electrotherapeutic modalities intend to:
- assist functional training
- assist muscle force generation & contraction
- Decrease unwanted muscular activity
- Increase the rate of healing of open wounds/soft tissue
- maintain strength after injury or surgery
- modulate of decrease pain
- reduce or eliminate soft tissue swelling, inflammation, or restriction
Electrotherapeutic delivery of medication
iontophoresis
Electrical Stimulation
- Electrical muscular stimulation ( EMS)
- electrical stimulation for tissue repair (ESTR)
- Functional electrical Stimulation (FES)
- High voltage pulsed current ( HVPC)
- Neuromuscular electrical stimulation (NMES)
- Transcutaneous electrical nerve stimulation (TENS)
Physical Agents
A broad group of procedures using various forms of energy that are applied to tissues in a systemic manner
Physical agents are intended to:
- Increase CT extensibility
- increase healing rate of open wounds and soft tissue
- Modulate pain
- reduce/eliminate soft tissue swelling or restriction associated with musculoskeletal injury or circulation dysfunction
- Remodel scar tissue
- Treat skin conditions
Athermal agents
Pulsed electromagnetic fields
Cyrotherapy
- Cold packs or ice packs
- ice massage
- ice immersion
- Vapocoolant spray
hydrotherapy
- Contrast baths
- Pools
- Pulsatile lavage (H20 to debride wounds)
- whirlpool tanks
light agents
- Infrared
- Laser
- Ultraviolet
Sound agents
- Phonophoresis
- Ultrasound
Thermotherapy
- Diathermy
- Dry heat
- Moist hot packs
- Paraffin baths
Mechanical modalities
A group of devices that use forces such as approximation, compression, and distraction
mechanical modalities intend to :
- improve circulation
- Increase ROM
- Modulate pain
- Stabilize an area that requires temporary support
Types of mechanical modalities
- compression therapy
- gravity assisted compression devices
- mechanical motion devices
- Traction devices
Compression therapies
- Compression bandaging
- Compression garment
- Taping
- Total contact casting
- Vasopneumatic compression devices
Gravity assisted compression devices
- Tilt table
- Standing frame
mechanical motion devices
-Continuous passive motion (CPM)
Traction devices
- Intermittent
- Positional
- Sustained
Physical agents primarily effective in what part of disablement model?
Impairment
- abnormality of structure (Tissue level)
Physical agents secondarily effective in what part of disablement model?
Pathology/ pathophysiology
- disease or injury (cellular level)
Reasons for interventions
- must understand why we are applying a physical agent
- Need to document clearly what & why we are doing something
Documentation
What we are doing and why
- type of modality
- location (body part)
- patient position
- dosage/time
- reason for intervention
Physiological properties that will be effected & can be manipulated by physical agents:
- Inflammatory process & tissue repair
- Pain
- Tone abnormalities
- motion restrictions
Steps to application of an electrophysical agent
- Communication
- Preparation
- Application
- Post application
Application of electrophysical agent: communication with yourself
- Is the PA appropriate for this patient’s impairment?
- is PA appropriate for the stage of healing?
- Does PA fit your therapy objective
Application of an electrophysical agent: communication with your patient
- Explain the procedure to the patient ( effects, feeling, how long, should be comfortable)
- tell your pt why you intend to use this PA to treat their impairment
- Explain the benefits
- Explain the precautions/risks
- Ask their permission
Application of Electrophysical agent: Prepare the patient
- Have pt expose part to be treated & remove jewelry
- inspect the area for lesions
- Perform and document pre-intervention test
- Position & drape pt appropriately being sensitive to cultural & individual differences
Application of Electrophysical agent: Prepare the physical agent
Select appropriate parameters
Application of Physical agent: Application
- Specific for each PA
- Reassess the treatment area frequently within first 5 minutes
- Set a timer and provide a call system for your patient
Application of electrophysical agent: Post application
- Remove PA
- Turn off PA
- Reassess treatment area and document properly
- continue with other treatment as indicated
perform post intervention test and document appropriately
Post application documentation
- Type of modality
- location (body part)
- patient position
- dosage/time
- reason for intervention
Risk management
- Process of analyzing exposure to risk and determining how to handle such exposure
- Provide safe environment for our patients
Risk management categories
- Near miss
- Incident
- Adverse event
- Sentinel Event
Near miss
potential to due harm that is identified before the event resulting in no harm to the patient
Incident
an event that has caused harm or has potential to cause harm to patinet
Adverse Event
Unintended injury or harm which results in disability or death and is caused by the management of the patients condition and not the disease process
sentinel event
A serious event that must be reported immediately to DHS
Risk management checklist
- Inspect skin before
- correctly apply PA
- Monitor pt
- reexamine post intervention
- Document
The Law
Education law
- Article 136, PT and PTAs
- NYS PT law article 136
- November 23, 2006
Duties of PTA do not include:
- Evaluation
- Testing
- Interpretation
- Planning or modification of pt programs
