PAMs

Question 1

What is AOTA’s official statement on the reason to use physical agent moralities?

Answer 1

to be “used as an adjunct or in preparation for a purposeful activity to enhance occupational performance.”

Question 2

What is cryotherapy?

Answer 2

therapeutic application of any substance to the body which results in withdrawal of heat from the body, thereby lowering tissue temperature

Question 3

Name the clinical indications for cryotherapy

Answer 3

acute injury and inflammation (24-48 hours post injury) usually in combination with compression and elevation, edema; post exercise edema or pain; arthritic flare up; spasticity; acute cumulative trauma, bursitis, tendinitis; acute or chronic pain due to muscle spasm; after exercise to maintain soft tissue elongation; facilitate muscle contraction (rood technique)

Question 4

What is the maximal depth cold will penetrate?

Answer 4

2 cm or 3/4 inch

Question 5

What are the effects of cold on the neurovascular system?

Answer 5

effects will last 45 minutes due to rewarming by blood from the rest of the body; contralateral effect via reflect action (i.e. other arm will respond but to a lesser degree); vasoconstriction (decreased blood flow); increased viscosity of the blood, “hunting reaction” sudden reddening and warming of cooled areas (occurs after 15 minutes)

Question 6

What are the physiological affects of vasoconstriction?

Answer 6

Decreased hemorrhage if applied 2-3 minutes after injury; decreased blood vessel diameter and blood flow; decreased capillary pressure and permeability (results in decreased swelling); histamine released is blocked

Question 7

What are the affects of cold on the neurovascular system?

Answer 7

effects will last 45 minutes due to rewarming by blood from the rest of the body; contralateral effect via reflect action (i.e. other arm will respond but to a lesser degree); vasoconstriction (decreased blood flow); increased viscosity of the blood, “hunting reaction” sudden reddening and warming of cooled areas (occurs after 15 minutes)

Question 8

What are the affects of cold on the neuromuscular system?

Answer 8

Decreased motor and sensory nerve conduction velocity; decreased muscle spasm and guarding; decreased speed of movement; decreased strength

Question 9

What should be documented when using thermal modalities?

Answer 9

Thermal agent (e.g. paraffin); rationale for use; application site (e.g. digits only); duration; special precautions (e.g. not over first dorsal compartment); adverse reactions if any; outcomes (e.g. patient’s hand less stiff)

Question 10

What are the stages of cooling?

Answer 10

Intense cold; burning; deep aching; analgesia (10-20 minutes after application)