Physical agent modalities (PAMs)

Question 1

Contraindications for heat:

Answer 1

Severe neurovascular compromise (DM, PVD), Increased bleeding or hemorrhage (hemophilia, acute trauma, long term steroid use with fragile capillaries), Do not lie on hot packs with body weight, Open wounds, Malignancy, pregnancy

Question 2

Contraindications for cold:

Answer 2

Extreme hypersensitivity to cold, Raynaud’s disease, Replantations, crush injuries, wounds

Question 3

Contraindications for e-stim:

Answer 3

Cardiac pacemakers, Active cancer, Local infections, Decreased cutaneous sensation, Pregnancy
Transcranial e-stim (CVA, seizures), Carotid artery or chest wall (cardiac)

Question 4

Superficial thermal agents

Answer 4

hot and cold

Question 5

Deep thermal agents

Answer 5

Ultrasound

Phonophoresis

Question 6

heat precautions

Answer 6

Monitor skin for mottled erythema after first 5 minutes
Monitor edema
Sensory deficits
Monitor older adults
Cardiovascular or pulmonary conditions
Use of anti-coagulants

Question 7

effects of heat

Answer 7

Pain relief
Improve ROM (greater extensibility of tissue)
Decrease joint stiffness
Relieve muscle spasms
Aid in reabsorption of exudate, edema (chronic conditions only!)

Question 8

effects of cold

Answer 8

Pain relief
Reduce (traumatic) edema
Reduce inflammation
Post-activity soreness
Decrease muscle guarding spasms

Question 9

effects of ultrasound

Answer 9

Heats deeper structures (tendon, ligament, articular capsule) for increased elasticity
Vasodilation
Pain relief (stimulates peripheral nerves)
Increases metabolic rate
Resolution of edema, inflammation
Enhance wound healing