Intro to Physical Agents Flashcards
physical agent (modality)
energy and materials applied to patients to assist with rehabilitation
categories of physical agents
thermal, mechanical, electromagnetic
thermal agents
transfer energy to increase or decrease temperature, superficial or deep tissue
thermotherapy (increase temperature)
use to increase circulation, metabolic rate, soft tissue extensibility, decrease pain
superficial thermotherapy
moist hot pack, water
deep thermotherapy
ultrasound, diathermy
cryotherapy (decrease temperature)
use to decrease circulation, metabolic rate, pain
superficial cryotherapy
cold pack, ice massage
mechanical agents
apply force to increase or decrease pressure on body
hydrotherapy
water with or without immersion, uses buoyancy to increase pressure of immersed body parts
- can provide resistance to motion and stabilize joints
- can be used for wound cleansing
traction
reduce pressure on compressed nerves or joints
compression
control or reverse edema by counteracting fluid pressure
electromagnetic agents
apply energy in form a electromagnetic radiation or electrical current
electromagnetic therapy
ultraviolet radiation, infrared radiation, diathermy (more common)
electrical current therapy
electrical stimulation to produce muscle contractions (motor), sensory changes (sensory level), reduce edema, accelerate healing
- wave current, intensity, and duration are altered depending on purpose
generic absolute contraindications
pregnancy, malignancy (cancer), pacemaker/implanted electronic device, impaired sensation, impaired mentation (cognitive)
relative contraindication (precaution)
conditions in which particular treatment should be used with special care or limitations
absolute contraindication (contraindication)
conditions in which treatment should NOT be applied
criteria for selecting physical agents
goals, influencing impairments, most effective with least risks, “first do no harm”
physical agent purposes
healing process, pain, motion restriction, muscle tone
progression of physical agent use during the inflammation process
most use: inflammation phase
least to no use: maturation phase
hypertonicity
tone can be increased in areas of pain or with central nervous system damage
hypotonicity
tone can be limited due to pain or decreased neural impulse transmission (peripheral nerve injury)
APTA statement interpretation
modalities should and can be used with other interventions to improve recovery
practical application of physical agents
early rehab: more use
middle of rehab: declined modality use
end of rehab: limited to no use
soap note implications
S: pt reports, improvements if any, response since last visit, current pain, etc.
O: setting of modality, placement, duration, intensity (should be able to read and duplicate treatment)
A: pt response to modality
P: what you plan to do next visit
physical agent use - immediate injury/acute inflammation
- reduce bleeding and further damage, limit motion to prevent damage, compression for stabilization
- control edema, pain, and bleeding
physical agent use - chronic inflammation
prevent stiffness, loss of motion, improve circulation, control pain, progress to proliferative phase
physical agent use - proliferative phase
control scar formation (collagen), ensure adequate circulation, regain ROM and strength
physical agent use - maturation phase
control scar formation, regain ROM and strength
physical agent use - acute pain
- address pathology and symptoms
- slow or block nerve conduction or speed
- endorphin release
- control inflammation process
- limit motion in painful area briefly
- unload compressed tissue
physical agent use - chronic pain
- address promotion of function
- limit use of passive modalities
- can use to promote activity tolerance and tissue mechanics
physical agent use - referred pain
- address origin
- can influence the dermatone area, etc.
- not very effective
physical agent use - complex regional pain syndrome
mild modalities to relieve pain symptoms and allow function
physical agent use - motion restriction
- address reason for motion restriction
- collagen is stretched most effectively when it is extensible, which can increase ROM
- choose agent that addresses collagen extensibility
physical agent use - muscle tone
- normally nerve pathology due to injury
- agents can alter nerve conduction, sensitivity, direct muscle function, and indirect muscle function
