Physical Agent Modalities

Question 1

physical agent modalities are defined as

Answer 1

superficial thermal agents, deep thermal agents, electrotherapeutic agents, and mechanical devices

Question 2

when can PAG be used in OT practice

Answer 2

in preparation for of concurrently with purposeful and occupation based activities that ultimately enhance engagement in occupation

Question 3

can PAG be used alone as OT treatment

Answer 3

no

Question 4

what must OTs have in order to use PAGs

Answer 4

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

Question 5

when is superficial heat used

Answer 5

chronic or sub acute conditions

Question 6

disadvantage of superficial heat

Answer 6

may exacerbate inflammation and swelling of acute injuries

Question 7

advantages of superficial heat

Answer 7

reduces pain
relaxes
increases superficial soft tissue extensibility

Question 8

conduction

Answer 8

occurs when two objects of different temps are in contact, heat moves from warmer to cooler objects

Question 9

convection

Answer 9

temperature of the heat source and amount of heat to skin is maintained

Question 10

what limits the depth of heat penetration

Answer 10

normal vascular responses

Question 11

how deep does superficial heat go?

Answer 11

.5 cm below skin surface

Question 12

what does heat do to vascular system

Answer 12

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

Question 13

what does heat do to skin

Answer 13

increases its elasticity and decreases its viscosity

may facilitate softening of scars

Question 14

what does heat do to muscles

Answer 14

may reduce protective muscle guarding and reduce musculoskeletal pain

Question 15

precautions of heat

Answer 15

• 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

Question 16

contraindications for heat

Answer 16

excessive damage to blood vessels of the skin

Question 17

how long is the total tx time for hot pack

Answer 17

15-20 min

Question 18

when should the patient’s skin be checked when using hot pack

Answer 18

after 5 minutes of applying

Question 19

when does the skin temperature peak during hot pack

Answer 19

8-10 min

Question 20

how many layers of towel should be used between hot pack and skin

Answer 20

6-8 towel layers

Question 21

what should the skin look like at 5 min check during hot pack

Answer 21

should feel warm but should not be red

Question 22

how long do the effects of hot pack last after treatment

Answer 22

~5min

Question 23

when is paraffin mostly used

Answer 23

to treat irregular skin surfaces such as fingers

Question 24

how many times does the client dip into the paraffin

Answer 24

8-10

Question 25

what should patient always do first before a treatment

Answer 25

wash hands

Question 26

what temp should the paraffin be at

Answer 26

126 degrees

Question 27

how long is the paraffin treated limb kept wrapped in plastic bag and towel

Answer 27

10-15 min

Question 28

total time in fluidotherapy

Answer 28

10-20 min

Question 29

what is usually done while pt is in fluidotherapy

Answer 29

exercises

Question 30

contraindications for fluidotherapy

Answer 30

open wounds | excessive damage to blood vessels of skin

Question 31

contraindications for paraffin

Answer 31

open wounds | excessive damage to blood vessels of skin

Question 32

what is hydotherapy mainly used for

Answer 32

debridement and healing of skin wounds

Question 33

what should the temperature be for whirlpool

Answer 33

100-104 for heating | 90-100 for open wounds

Question 34

recommended tx time for whirlpool

Answer 34

20 min

Question 35

what type of heat is infrared

Answer 35

conversion heat

Question 36

how deep does near infrared heat penetrate

Answer 36

5-10mm

Question 37

how deep does far infrared penetrate

Answer 37

2mm

Question 38

what is superficial cold used to treat

Answer 38

musculoskeletal pain muscle guarding spasticity acute inflammation (swelling)

Question 39

physiological effects of superficial cold

Answer 39

causes vasoconstriction and reduces blood flow to area

Question 40

why does the skin turn white initially when cold is applied

Answer 40

vasoconstriction happens and blood is shunted away from skin

Question 41

why does skin eventually turn red after cold is applied for awhile (10-15 min)

Answer 41

vasodilation occurs to direct blood to the skin to prevent damage to the skin

Question 42

how does cold act upon peripheral nerves

Answer 42

decreases conduction velocity and synaptic activity inhibits pain signals dampens nerve activity relating to painful spasticity

Question 43

how does superficial cold act on soft tissue

Answer 43

increases viscosity decreases elasticity increased stiffness

Question 44

clinical effects of superficial cold

Answer 44

temporary relief from musculoskeletal pain decrease edema decrease muscle guarding and spasticity promote active and passive mobility decrease post exercise soreness and swelling

Question 45

precautions of cold

Answer 45

compromised neurovascular response to cold (monitor closely)

Question 46

how long is cold pack applied to patient

Answer 46

15 min

Question 47

how long is ice massage applied

Answer 47

5-10 min or until skin flushing and numbness occurs

Question 48

contraindications for cols

Answer 48

``` extreme hypersensitivity to or allergy to cold severe Reynauds replantations crush injuries healing wounds ```

Question 49

what ratio of warm to cold water is recommended for contrast bath

Answer 49

3:1 | typically start with warm and end with warm, but if edema is an issue, can end with cold

Question 50

how long should total tx be for contrast bath

Answer 50

10-15 min

Question 51

when to use contrast bath

Answer 51

edema | pain and stiffness

Question 52

contraindications for ultrasound

Answer 52

``` pacemaker malignancy over growth centers healing fx early tendon healing over metal or prosthetic implants ```

Question 53

phonophoresis

Answer 53

use of ultrasound to enhance delivery of topically applied drugs -need doc order

Question 54

electrical therapy

Answer 54

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

Question 55

current

Answer 55

flow of electrons (amps)

Question 56

voltage

Answer 56

electromotive force that drives the current (volts)

Question 57

Resistance

Answer 57

opposition to current flow (ohms)

Question 58

direct/Galvanic current

Answer 58

continuous flow of current and unchanging in amplitude

Question 59

interferential current

Answer 59

produced by combining 2 medium frequency alternating currents

Question 60

alternating current

Answer 60

uninterrupted current flow that is constantly changing polarity with equal number of negative and positive phases

Question 61

TENS

Answer 61

applying low voltage electrical pulses to nervous system for pain control

Question 62

iontophoresis

Answer 62

using electrical current in one direction to deliver anti-inflammatory medication

Question 63

medications administered via iontophoresis

Answer 63

dexamethasone | lidocaine

Question 64

precautions/contraindications for ionto

Answer 64

pregnancy allergy to med Type I diabetes will notice difference in blood glucose levels