Introduction to Physical Agents Flashcards
What are physical agents?
energy and materials applied to the body
Type of energy
sound
electrical
heat
mode of energy application
ultrasound,NMES,hot pack, etc.
What do physical agents do?
modify tissue inflammation and healing
relieve pain
alter collagen extensibility
modify muscle tone/ contracting ability
Thermal Agents
deep-heating (ultrasound, diathermy)
superficial-heating (hot pack, paraffin)
superficial cooling (ice pack, ice massage)
Mechanical Agents
traction
compression (bandage, stockings)
water (whirlpool)
sound (ultrasound)
Electromagnetic
electromagnetic fields (UV, laser ) electrical currents (TENS, NMES, high volt, iontophoresis, EMG)
General Precaution/Contraindications
Pregnancy- could potentially hurt the fetus
Malignancy- could increase growth of metastasis
Decreased sensation/mentation- no report of feeling
pacemaker/.electronic devices- energy could reach
Which is the highest priority of choosing an agent?
First priority is to address the primary underlying problem or the problem most likely to respond to treatment
Which is the last priority for choosing an agent?
symptomatic treatment only
Treatments that address more than one problem simultaneously……
are considered second in priority level
Hierarchy of choosing a physical agent
goals and effects of treatment
contraindications and precautions
evidence for physical agent use
cost,convenience and availability
Three pillars of EBP
best available evidence
patient values
clinical experience
What are some cost effective uses of modalities?
- asses and analyze presenting problem
- know when agents can be effective for treatment
- know when and how to use them most effectively
- know the skill level required for application
- use home programs when appropriate
- treat in groups when appropriate
- reassess patients regularly to determine efficacy
- adjust plan of care according to reassessment
What is the most common symptom prompting patients to seek medical attention and rehab?
PAIN
Pain is…
an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
What is transient pain?
pain that goes away without treatment
It is brought on by activation of nocioceptive tissues in the body where there is no tissue damage
What is acute pain?
pain brought on by tissue injury and activation of nocioceptors at the site of injury
What is persistent pain?
pain that begins with injury or disease but is perpetuated by factors other then the initial cause of pain
there is an emotional component
A Delta: primary afferent neuron
responds to intense mechanical stimulation and heat or cold
short duration, sharp, stabbing or pricking sensation
small and myelinated
makes up 20% of pain afferents
Not blocked by opiods
C Afferent: primary afferent neuron
longer duration, dull throbbing, aching, burning, tingling, diffusely located
accompanied by sweating, increased HR, BP and nausea
small and UNmyelinated
makes up 80% of pain afferents
CAN be blocked by opiod medication
A-beta: primary afferent neuron
non-painful sensation related to vibration, stretching and mechanical pressure
What are nociceptors?
non-adaptive, specialized nerve endings that are sensitive to mechanical stress or trauma, extreme heat/cold or chemicals
Neuropathic pain
burning or lancinating quality
usually accompanied by signs or symptoms of neurological dysfunction (parasthesia, itching, weakness)
What is radicular pain?
pain that travels along a nerve
What is referred pain?
pain that may be acute or chronic and is away from the origin/source of pain
What is the specificity theory of pain?
pain that is experienced as a result of the action of peripheral nerve fibers
What is the pattern theory of pain?
pain that can be experienced by the stimulation of any sensory receptor as long as stimulation is intense enough
What is the gate-control theory?
a-delta and c fibers transmit nociceptive signals to the the thalamus
whereas A-alpha and A-beta (non-nocicpetive) fibers transmit signals that INHIBIT pain signals to the thalamus
Where does pain originate?
Pain is 100% from the BRAIN
