week 11 Flashcards
Physical agent modalities (PAMs)
procedures and
interventions that are applied to alter specific client factors,
such as body functions related to pain and neuromusculoskeletal
INDICATIONS/BENEFITS OF HEAT
↑Blood flow
↑Cellular metabolic rate
↑Inflammatory response
↑Edema, and prevent adhesion formation
↑Extensibility of collagen
↓Joint stiffness
↑Relief of muscle spasm
↓Pai
INDICATIONS/BENEFITS OF COLD
↓Circulation
↓Metabolism
↓Inflammatory effects
↓Secondary trauma that can occur following injury
↓Histamine release
↓Swelling, bleeding
↓Inflammation
↓Pain
Hot Packs
-Cause a superficial (shallow) change in skin 1-2 cm
-104°F to 113° F
-Stored in a hydrocollator
-six to eight layers of towels between the pack and the client’s skin
-Application time is typically 20 minutes
Contraindications for application of hot packs include clients
with
▪ Significant circulation impairments or edema
▪ Acute inflammatory phase of healing
▪ Tumors or cancer
▪Deep venous thrombosis
▪Bleeding conditions
▪ Advanced cardiac disease
▪ Impaired cognitive status or decreased consciousness
▪ Poor thermal regulation
▪Rheumatoid arthritis
Fluidotherapy
-closed unit containing finely ground cellulose particles
made from corn cob particles.
▪ heat is maintained consistently during the treatment
-100° to 118°
Fluidotherapy should not be used with clients who have the following conditions:
Impaired sensation (with heat)
▪ Poor thermoregulation
▪ Open wounds
▪ Infections
▪ Contagious diseases
▪ Tumor/cancer
▪ Acute inflammation and acute edema
Paraffin
-melted wax that is mixed with mineral oil in a 6:1 or 7:1 ratio
-126° F to 134° F
-for arthritis, systemic sclerosis
decreased ROM, scars,
contracture, and pain control
-Treatment time is 20 minutes.
Contraindications for paraffin
open wounds, skin infections, sensory loss, and peripheral vascular disease
Cryotherapy
-cold for therapeutic benefits and consists of ice massage, cold packs, cold baths, or ice bags
Contraindications: for cryotherapy
-Some rheumatoid conditions
-Very young/very old clients,
▪History of frostbite in the area
- Impaired circulation
▪ Peripheral vascular disease
▪Open wounds
▪Local infection
-Raynaud’s phenomenon
-cold sensitive conditions
Contrast Bath
-immersion of a body
part with heated water (105° F to 110° F) and then another with cold water (50° F to 60° F)
-20 to 30 minutes
-hot immersions is typically 3 to 4 minutes, whereas that of cold immersions is 1 to 2 minutes
-treating subacute or chronic
inflammatory conditions, edema, pain reduction, and increasing joint ROM
Contraindications for contrast bath
acute injuries, hypersensitivity to cold, and those related to cold and heat applications.
Deep Thermal Modalities
penetrate to the depth of less than 2 cm
Ultrasound
diagnosing conditions and imaging structures; in rehabilitation, it is used for producing thermal and
nonthermal effects on tissue and deeper structures.
Contraindications for ultrasound
-not be applied to the eyes or genitals, directly over a bony
prominence, near the heart or a pacemaker or its components, and to the epiphyseal
growth plate, ischemic tissues, or insensate areas
-pregnacy
-to 14 total treatments because more than 14 treatments can decrease both red and white blood cell counts
Phonophoresis
enhance the delivery of topically
applied drugs
-possible drug
allergies
Iontophoresis
- continuous flow of unidirectional electrons
between + & - - primarily used for iontophoresis, using current instead of sound waves.
▪ DC is also used to stimulate denervated muscle
-watch for drug allergies
Neuromuscular
electrical stimulation (NMES)
-electrical stimulation of muscles
-improving muscle
strengthening and functional usage
Interferential
Current
-two separate channels
delivering different frequencies of electrical stimulation
simultaneously
-primarily used for pain relief
TENS
Transcutaneous electrical nerve stimulation
-utilizes electrodes to deliver
pulsed current to stimulate nerves for relieving pain
Diathermy
Application of moderate heat to increase blood flow and heat fibrous tissues.
▪ Facilitates the relief of joint stiffness, promotes muscle relaxation, and decreases
muscle spasms
Laser Light
-light amplification by stimulated emission of radiation
-utilized for tissue healing in wounds and for management of
pain associated with arthritis and neuromusculoskeletal conditions
Precautions and Contraindications of laser light
-always wear goggles
-pregnant and impaired sensation
-burns
-no eyes
-▪ Malignancy
▪ Within 4 to 6 months after radiation treatment,
▪ Over hemorrhaging regions
▪ Over the thyroid and other endocrine glands.
Mechanical Modalities
consist of tools that
apply force as part of the treatment
Vasocompression units
-to reduce swelling, to, the extremities after surgery or for treating chronic conditions
- move fluid from intracellular tissues to lymphatic capillaries to then be transported out of the body through the lymphatic system
Contraindications Vasocompression units
Malignancy in the treatment area
▪DVT
▪Obstructed lymphatic channels, such as sclerotic lymphedema
▪Unstable or acute fracture in the treatment area
▪Heart failure
▪ Infection in the treatment area
▪Pulmonary edema
▪ Kidney or cardiac insufficiency
▪Clients who are very young or those who are very old and frail
Continuous
Passive Motion (CPM)
- provides early protected motion to healing soft tissues
- used for treating elbows, shoulders, and knees
for contractures or mobilization after surgery to enhance
connective tissue strength, facilitate ROM, and evacuate joint hemarthrosis
