Physical Agents

Question 1

What is a physical agent? What is the role of a physical agent?

Answer 1

Physical modality applied to the body for the purpose of decreasing pain, increasing ROM, tissue healing, muscle activation

COMPLEMENTS treatment, does NOT replace it

Question 2

What are the 3 categories of PAs? How do they provide rehabilitative effects? List examples of each.

Answer 2

Thermal: transfers energy to decrease/increase tissue temp.

• **Heat (paraffin, heat pack, ultrasound/diathermy) Ice
• ** promote vasoconstriction or vasodilation

Mechanical: increase/decrease pressure in body

• ** Traction, compression, water, sound
• **US induces vibration of particles to increase friction which increases tissue temp

Electrical: alters permeability of membrane

• **TENS, electrical current/stimulation
• **depolarizes nerves, facilitates muscle contraction, pain control

Question 3

What are the 5 general contraindications for PAs?

Answer 3

1. Impaired Mentation
2. Impaired Sensation
3. Pacemaker (be aware of area of application)
4. Pregnancy
5. Malignancy

Question 4

Ultrasound and water fall under what two types of PAs?

Answer 4

Mechanical and Thermal

Question 5

Physical agents have a direct effect on what?

Answer 5

LEVEL OF IMPAIRMENT

Can improve functional limitations and disability

Question 6

PAs are used in conjunction with or in preparation to:

Answer 6

Therapeutic exercise

Functional Training

Question 7

How do PAs assist in decreasing inflammation and increasing tissue healing?

Answer 7

Thermal: change rate of circulation and chemical reactions

Mechanical: control motion and alter fluid flow

Electrical: alter cell function, membrane permeability and transport

Question 8

What 4 things take place during the inflammatory phase?

Answer 8

Vasodilation
Vasoconstriction
Clot formation
Phagocytosis

Question 9

What 4 things take place during the proliferation phase?

Answer 9

Epithelialization
Neovascularization
Collagen Formation
Wound Contracture

Question 10

What 3 things take place during the maturation phase?

Answer 10

Collagen Synthesis
Collagen Fiber Orientation
Healed Injury

Question 11

What accounts for 50% of the complications of wound healing?

Answer 11

INFECTION

Question 12

What are the 4 cardinal signs of inflammation?

Answer 12

Pain
Heat
Redness
Swelling

Question 13

Stage of healing determine what two factors?

Answer 13

1. Treatment Goals

2. Choice of physical agent

Question 14

What are the treatment goals for the initial injury stage? What PAs should be used?

Answer 14

Tx Goals: Control bleeding/inflammation and clean wound

PAs: Compression, cryotherapy, and hydrotherapy

Question 15

What are the treatment goals for the acute stage of injury? What PAs should be used?

Answer 15

Tx goals: control pain, edema, bleeding, inflammation

PAs: Cryotherapy, Hydrotherapy, Electrical Stimulation, Pulsed Short Wave US

Question 16

What are the treatment goals for the chronic stage of injury? What PAs should be used?

Answer 16

Goals: Decrease Joint stiffness, control pain, increase circulation

PAs: thermal therapy, electrical stimulation, whirlpool, hydrotherapy, compression

Question 17

What are the treatment goals for the maturation stage of injury? What PAs should be used?

Answer 17

Goals: maintain strength, flexibility, and control scar tissue formation

PAs: water and moderate exercise, thermotherapy, ice massage and compression

Question 18

What do cutaneous, musculoskeletal, and visceral pain present as?

Answer 18

Cutaneous: well localized, sharp, prickling, tingling

Musculoskeletal: poorly localized, dull, heavy, aching

Visceral: aching and refers superficially

Question 19

What for physical Agents are most commonly used for pain reduction?

Answer 19

Cryotherapy
Thermal therapy
Electrical stimulation
Traction

Question 20

What is hypotonicity? What conditions are associated with hypotonicity? Physical agent?

Answer 20

Abnormally Low tone

Associated with down syndrome and poliomyelitis

Motor ES or quick ice to antagonist

Question 21

The total absence of tone is known as? What PA is used?

Answer 21

Flaccidity

Motor electrical stimulation

Question 22

What is hypertonicity? Explain rigidity, spasticity and clonus. What physical agent is typically used for treatment?

Answer 22

Rigidity is velocity INDEPENDENT resistance to stretch

Spasticity is velocity DEPENDENT resistance to stretch

Clonus is a sustained contraction in response to quick stretch

Neutral warmth or prolonged cryotherapy