Superficial Heat Agents

Question 1

Superficial Heat Agents (Definition)

Answer 1

Therapeutic application of any modality to the skin which results in an increased skin and superfical subcutaneous tissue temp. (1-2cm deep)
Produces a moderate dose of increase in body tissue to 102-106 degrees with a slight increase in blood flow lasting up to 20 minutes post tx.

Question 2

Conduction (definition)

& 3 heat modalities that use conduction

Answer 2

Heat on the skin causes a transfer of energy

Hot pack, contrast bath, paraffin.

Question 3

Convection (definition)

& 2 heat modalities that use convection

Answer 3

Conveyance of heat by the movement of heated particles (water, air, or fibers)
Whirlpool, fluidotherapy.

Question 4

Heat modalities are good for (8) specific symptoms/dx.

Answer 4

1) Stiff joints
2) Muscle spasams
3) Subcutaneous adhesions
4) Contractures
5) Chronic Arthritis
6) Subactue/Chronic inflammation
7) Neuromas
8) Sympathetic nervous system disorders (chronic regional pain syndrome)

Question 5

Heat modalities produce 4 specific effects

Answer 5

1) Analgesic effect
2) Vascular
3) Metabolic
4) Connective tissue (collogen/extensibility)

Question 6

How do heat modalities produce an analgesic effect

Answer 6

They reduce pain by acting on free nerve endings, tissues, and peripheral nerve fibers.

Question 7

How do heat modalities produce a vascular effect

Answer 7

6-14 degree increase in tissue temp. facilitates the release of substances such as histamine that result in vasodilation.
Increase in blood flow reduces ischemia, muscle spindle activity, and tonic muscles contractions which aids in pain relief and decreased muscle spasms.

Question 8

How do heat modalities produce a metabolic effect

Answer 8

Increase of blood flow and oxygen with tissue brings greater anitbodies, leukocytes. nutrients, and enzymes to injured tissues which aids in pain relief and tissue repair.

Question 9

How do heat modalities effect connective tissue

Answer 9

They improve the properties of collagen and extensibility of the tissue when combined w/ movement.

Question 10

Used when a quick and low maintenance heat is adequate for delivering heat.

Answer 10

Hot pack (beware of the weight on pts.)

Question 11

Water bath with aeration used when buoyancy and ease of movement is desired.

Answer 11

Whirlpool

Question 12

Fine particles called celloulus from ground up corn husks are suspended in air

Answer 12

Fluidotherapy

has a higher heat level

Question 13

Immersion in a wax

Answer 13

Paraffin

Question 14

What do hot packs allow for

Answer 14

Allows for stretch and elevation but not movement

Question 15

What are whirlpools primarily good for

Answer 15

Good for use with open wound w/o heat.

Good for cleaning and debridement.

Question 16

What is fluidotherapy primarily used for

Answer 16

Used for the benefits of stretch and desensitization

Question 17

When is paraffin primarily used

Answer 17

Used when an even distribution of heat is desired or when hand joints specifically need heating.
(can be used in conjunction with a passive stretch of a digit)

Question 18

Contraindications for heat modalities (3)

Answer 18

1) Acute injury or inflammation
2) Impaired sensation (worse then a 2.83 on Semmes Weinstein)
3) Malignancy

Question 19

Precautions for heat modalities (9)

Answer 19

1) Mild impaired sensation
2) Tumors/Cancer in the past
3) Acute inflammation
4) DVT
5) Bleeding tendencies
6) Infection
7) Advanced cardiac disease
8) Impaired mental status
9) RA

Question 20

Hot Pack Application and time frame

Answer 20

Clay pack stored in water of (165-170 for heating, 90-100 for wounds), placed in a cover then layered with towels.
Total of 6-8 layering of toweling with the cover counting as 3 layers.
More layers if “sandwiched” or laying a body part on top of heat).
Hot pack is then placed on the area assuring positioning allows for relaxation of the area as well as elevated if needed for edema.
Delivers heat at a 105-113 level.
Leave on for 15-20min.

Question 21

Whirlpool Application and time frame

Answer 21

Fill the whirlpool monitoring the temp. (100-104 for heating, 90-100 for wounds).
Position pt. close using towels to protect clothing, adjust height of whirlpool to assure for max comfort/coverage.
Turn on and adjust agitation to pt. comfort.
Tx. time is 20min.

Question 22

Fluidotherapy application and time frame

Answer 22

Preheat unit to 105-118 degrees.
Wash hands and thoroughly dry, remove jewelry.
Position pt. so both legs are positioned on one side of the machine so they can move as close as possible.
Open the arm sleeve, have the pt. insert their arm and wrap the velcro closure snuggle around the upper arm.
Adjust the setting to 15-20min and after beginning adjust the agitation level (higher creates more buoyancy and lower creates more desensitization).

Question 23

Paraffin application and time frame

Answer 23

Remove jewelry, clean and thoroughly dry hand.
Check that wax is at the right temp (118-135)
With fingers apart, have pt. slowly immerse hand into wax avoiding contact with the sides and bottom (demo first).
Allow to air dry a few seconds until it loses its shiny appearance.
Dip 6-10 times until a thick coating is achieved.
Wrap in plastic bag then towel or mitt.
Leave on x15min.
Remove paraffin then discared.
Can be combined w/ another heat modality.

Question 24

uses the effects of heat and cold modalities in combination.

Answer 24

Contrast bath

Question 25

What do contrast baths produce and improve

Answer 25

Produces alternating vasodilation and vasoconstriction which improves peripheral blood flow.

Question 26

What 2 things do contrast baths reduce

Answer 26

1) Edema

2) Pain; esp. seen in those w/ hypersensitivity.

Question 27

Precautions and Contraindications of contrast baths

Answer 27

Include those listed for both cryotherapy and heat therapy.

Question 28

Contrast bath application and time frame

Answer 28

Fill two containers side by side with water.
One is warm (100-110) and one is cold (50-70)
Pt. immerses their hand in warm water x4min and then cold x1min.
Pt. alternates back and forth for 20-30min ending on warm.

Question 29

Temp. for Hot Pack

Answer 29

Stored in water which is 165-170

Delivers Heat at a 104-113 level

Question 30

Temp for Whirlpool

Answer 30

100-104 for heating

90-100 for wounds

Question 31

Temp for fluidotherapy

Answer 31

105-118

Question 32

Temp for paraffin

Answer 32

118-135

Question 33

Temp for contrast baths

Answer 33

Hot: 100-110
Cold: 50-70