Thermotherapy

Question 1

Superficial PAMs depth

Answer 1

Penetrates to a depth of 1-2 cm

Question 2

Deep PAMs penetration depth

Answer 2

Penetrates to a depth of 5 cm

Question 3

Indications for thermotherapy

Answer 3

Subacute or chronic inflammation or pain
Subacute strain or sprain
Subacute edema removal or swelling
Decreased ROM
Myofascial trigger points
Muscle guarding
Muscle spasm
Subacute contusion
Infection

Question 4

Thermotherapy contraindication

Answer 4

Acute inflammation
Acute edema
Deep vein thrombophlebitis
Bleeding tendency
Infection
Primary repair of tendon or ligament
Advanced cardiac disease
Semicomatose or impaired mental status
Acute musculoskeletal conditions
Impaired circulation
Peripheral vascular disease
Skin anesthesia
Open wounds or skin conditions
Increase in hydrostatic pressure

Question 5

Effect of heat on metabolism

Answer 5

Increased local metabolism
Increased metabolic wastes
Increased inflammation
Increased oxygen consumption

Question 6

Effect of heat on muscle

Answer 6

Increased local temperature
Increased tissue elasticity
Decreased muscle tone
Decreased spasticity
Increased contraction velocity
Decrease in stiffness

Question 7

Effect of heat on nerve conduction

Answer 7

Increased axon reflex activity
Decreased pain due to counter-irritation

Question 8

Effect of heat on circulation

Answer 8

Vasodilation of arterioles and capillaries
Increased capillary permeability
Increase blood flow
Increased lymphatic and venous drainage
Increased formation of edema
Decreased blood viscosity
Increased intravascular pressure
Increased inflammation

Question 9

Radiation

Answer 9

Energy transferred through space to extremity

Question 10

Target soft tissue temperature

Answer 10

104-113 F
Below 104, therapeutic response will not be achieved
Above 113 F, catabolism and cell death will occur
116 F will burn skin

Question 11

Application of hot packs

Answer 11

158-168 F degrees
Remove hot pack from hydrocollator (158-168 F) and place in hot pack cover or 6-8 layers of dry Turkish towels
- Hot pack cover = 2 layers
Apply to body segment and secure
Start treatment timer for 20 minutes and advise to immediately indicate if hot pack feels to hot
At 5 minutes, check patient’s status and assess for burning, blistering, or excessive redness
Briefly apply a cold pack if there is overheating
At the end of 20 minutes, remove towels and hot pack, check patient’s status, and check to see if treated area is slightly red and warm to touch
Place hot pack back in hydrocollator to reheat for 30-120 minutes

Question 12

Advantages of hot packs

Answer 12

Body segment can be placed into sustained positional stretch to increase ROM
Easy to use and minimal maintenance
Moderate to vigorous doses of heat that penetrates 1-2 cm

Question 13

Disadvantages of hot packs

Answer 13

Skin cannot be observed
Patient may not be able to tolerate weight/heat
Weight can accelerate rate of transfer
May not allow AROM during heating

Question 14

Paraffin bath application

Answer 14

Heat bath to more than 125 F
Have patient wash and dry body part
Hold hand with fingers slightly spread and dip hand into paraffin bath
Remove hand and hold it over paraffin mixture until hand and stops dripping
Repeat process 10 times
After last dip, cover hand with plastic wrap and drape it with a paper towel
Set treatment timer for 20 minutes
Tell patient to inform if paraffin is too hot or uncomfortable
At 5 minutes, verbally check patient’s status
At end of 20 minute session remove towel and plastic wrap and discard paraffin
Treated area should appear slightly red and be warm to the touch

Question 15

Advantages of paraffin bath

Answer 15

Easy to apply, inexpensive
Efficient when treating small joints of distal extremities
Evenly applies moderate to vigorous heat that penetrates 1-2 cm to decrease stiffness and pain in joints, reduce pain in soft tissue, and improve range of motion
Mineral oil in mixture lubricates skin
Passive stretch can be sustained throughout heat application with Coban
Effective for rheumatoid arthritis when a moderate amount of heat is applied

Question 16

Disadvantages of paraffin bath

Answer 16

Messy
Skin is not visible for inspection during procedure
Expensive to replace wax mixture
Danger of contamination
Need to clean bath

Question 17

Fluidotherapy

Answer 17

Special chamber that suspends finely ground cellulose particles in warm air to provide heat, massage, and sensory stimulation

Question 18

Fluidotherapy application procedures

Answer 18

Preheat fluidotherapy unit to desired temperature
Wash and dry hands
Apply clean bandage over any open wounds and cover with a plastic bag
Check the controls to ensure unit is turned off
Place client’s hand through portal
Have patient place unaffected hand in second unit portal
Set temperature gauge to desired level
Turn machine on and adjust degree of air flow and agitation and set treatment timer for 20 minutes
At end of 20 minutes remove hands
Treated area should appear slightly red and warm to the touch

Question 19

Fluidotherapy advantages

Answer 19

Easy to operate
Temperature can be regulated to evenly provide mild, moderate, or vigorous heat
Air flow can be controlled to provide oscillating pressure to decrease edema and treat hypertension
Stimulation of sensory receptors and oscillating environment decreases sensitivity to pain
Analgesic effects can be obtained at lower temperatures
Higher temperatures can enhance tissue elasticity, reduce viscosity and improve joint mobility
PROM, AROM, and AAROM are possible during application

Question 20

Fluidotherapy disadvantages

Answer 20

Only applicable to distal extremity
Hands must be in a dependent position
Treatment can be messy
Expensive unit