Physical Agent Modalities Flashcards
physical agent modalities are defined as
superficial thermal agents, deep thermal agents, electrotherapeutic agents, and mechanical devices
when can PAG be used in OT practice
in preparation for of concurrently with purposeful and occupation based activities that ultimately enhance engagement in occupation
can PAG be used alone as OT treatment
no
what must OTs have in order to use PAGs
demonstrated verifiable competence
must have documented evidence of possessing theoretical background and technical skills for safe and competent integration of the modality into OT tx
when is superficial heat used
chronic or sub acute conditions
disadvantage of superficial heat
may exacerbate inflammation and swelling of acute injuries
advantages of superficial heat
reduces pain
relaxes
increases superficial soft tissue extensibility
conduction
occurs when two objects of different temps are in contact, heat moves from warmer to cooler objects
convection
temperature of the heat source and amount of heat to skin is maintained
what limits the depth of heat penetration
normal vascular responses
how deep does superficial heat go?
.5 cm below skin surface
what does heat do to vascular system
increases blood flow to area
increased release of histamine, bradykinin, and prostaglandin at the site
relaxtion of smooth muscle of blood vessels
increases capillary permeability
what does heat do to skin
increases its elasticity and decreases its viscosity
may facilitate softening of scars
what does heat do to muscles
may reduce protective muscle guarding and reduce musculoskeletal pain
precautions of heat
- can cause edema
- closely monitor patients with scars or decreased sensation for signs of excessive heating
- do not leave patients with unmanaged blood pressure, vertigo, seizure disorders should not be left unattended
contraindications for heat
excessive damage to blood vessels of the skin
how long is the total tx time for hot pack
15-20 min
when should the patient’s skin be checked when using hot pack
after 5 minutes of applying
when does the skin temperature peak during hot pack
8-10 min
how many layers of towel should be used between hot pack and skin
6-8 towel layers
what should the skin look like at 5 min check during hot pack
should feel warm but should not be red
how long do the effects of hot pack last after treatment
~5min
when is paraffin mostly used
to treat irregular skin surfaces such as fingers
how many times does the client dip into the paraffin
8-10
what should patient always do first before a treatment
wash hands
what temp should the paraffin be at
126 degrees
how long is the paraffin treated limb kept wrapped in plastic bag and towel
10-15 min
total time in fluidotherapy
10-20 min
what is usually done while pt is in fluidotherapy
exercises
contraindications for fluidotherapy
open wounds
excessive damage to blood vessels of skin
contraindications for paraffin
open wounds
excessive damage to blood vessels of skin
what is hydotherapy mainly used for
debridement and healing of skin wounds
what should the temperature be for whirlpool
100-104 for heating
90-100 for open wounds
recommended tx time for whirlpool
20 min
what type of heat is infrared
conversion heat
how deep does near infrared heat penetrate
5-10mm
how deep does far infrared penetrate
2mm
what is superficial cold used to treat
musculoskeletal pain
muscle guarding
spasticity
acute inflammation (swelling)
physiological effects of superficial cold
causes vasoconstriction and reduces blood flow to area
why does the skin turn white initially when cold is applied
vasoconstriction happens and blood is shunted away from skin
why does skin eventually turn red after cold is applied for awhile (10-15 min)
vasodilation occurs to direct blood to the skin to prevent damage to the skin
how does cold act upon peripheral nerves
decreases conduction velocity and synaptic activity
inhibits pain signals
dampens nerve activity relating to painful spasticity
how does superficial cold act on soft tissue
increases viscosity
decreases elasticity
increased stiffness
clinical effects of superficial cold
temporary relief from musculoskeletal pain
decrease edema
decrease muscle guarding and spasticity
promote active and passive mobility
decrease post exercise soreness and swelling
precautions of cold
compromised neurovascular response to cold (monitor closely)
how long is cold pack applied to patient
15 min
how long is ice massage applied
5-10 min or until skin flushing and numbness occurs
contraindications for cols
extreme hypersensitivity to or allergy to cold severe Reynauds replantations crush injuries healing wounds
what ratio of warm to cold water is recommended for contrast bath
3:1
typically start with warm and end with warm, but if edema is an issue, can end with cold
how long should total tx be for contrast bath
10-15 min
when to use contrast bath
edema
pain and stiffness
contraindications for ultrasound
pacemaker malignancy over growth centers healing fx early tendon healing over metal or prosthetic implants
phonophoresis
use of ultrasound to enhance delivery of topically applied drugs
-need doc order
electrical therapy
use of electrical currents to stimulate membranes of nerves, muscles, and other soft tissue to restore fxn
used to promotes muscle activity and modulate pain
current
flow of electrons (amps)
voltage
electromotive force that drives the current (volts)
Resistance
opposition to current flow (ohms)
direct/Galvanic current
continuous flow of current and unchanging in amplitude
interferential current
produced by combining 2 medium frequency alternating currents
alternating current
uninterrupted current flow that is constantly changing polarity with equal number of negative and positive phases
TENS
applying low voltage electrical pulses to nervous system for pain control
iontophoresis
using electrical current in one direction to deliver anti-inflammatory medication
medications administered via iontophoresis
dexamethasone
lidocaine
precautions/contraindications for ionto
pregnancy
allergy to med
Type I diabetes will notice difference in blood glucose levels
