Week 3 - Physical Agent Modalities in OT Flashcards
procedure & interventions that are systematically applied to modify client factors that may limit occupational performance; uses various forms of energy to modulate pain, modify tissue healing, increase tissue extensibility, modify skin and scar tissue, decrease edema, and decrease inflammation.
PAMs
Name 3 conditions that PAMs are useful for.
- soft tissue injury
- acute/chronic pain
- impaired muscle function
Are PAMs used in OT as an exclusive therapeutic intervention without application to occupational performance?
NO
PAMs are to be used by OTs before or after ___ ___ that ultimately enhance engagement in occupations.
therapeutic activities
PAMs
interventions that produce a response in soft tissue through the use of light, water, temperature, sound or electricity.
Name 3 categories of PAMs.
- thermal
- electromagnetic
- mechanical
Is the selection, application and adjustment of PAMs an entry level OT skill?
NO
OTs who use PAMs must ____ theoretical and technical knowledge.
document
OTs must adhere to ___ or institutional rules/guidelines.
state
What is the goal of PAMs?
to produce a response in soft tissue that has been injured.
- predictable overlapping sequence of events
- cellular activity - phagocytosis, neovascularization, biosynthesis of reparative collagen
wound healing
Wound healing can be impeded by ____.
infection
inflammatory response remains at ____ ____.
wound edges
tensile strength ___ reaches pre-injury status
NEVER
Name the 3 phases of wound healing.
In Front of Me
- Inflammatory phase
- Fibroblastic/Proliferative phase
- Maturation (Scar remodeling) phase
- initial response to injury that is vascular and cellular
- goals of this phase: defend against alien substances, dispose of dead and dying tissue
- prepare tissue for repair process.
- 24-48 hours, completed in 7 days.
Inflammatory phase
What is the goal of the inflammatory phase?
to not disrupt healing process
- follows phagocytosis
- collagen deposition
- granulation tissue formation
- begins day 5, completed 2-3 weeks
proliferative (fibroblastic) phase
- balance of collagen breakdown and formation
- scar becomes more elastic, smoother, stronger
- 2 weeks to 1 year
maturation (remodeling) phase
Name the 4 primary effects of superficial heat.
- analgesic
- vascular
- metabolic
- improvement in properties of collagen and extensibility of tissue.
Analgesic
heat acts on nerve endings
vascular
heat decreases muscle spasms
metabolic
increased blood flow from heat helps tissue repair
What is a general requirement for PAM use in the clinic?
-MD prescription is required!
Name 3 methods of temperature transfer used for thermal PAMs.
- conduction
- convection
- conversion
the transfer of energy from a warmer substance to a colder one through direct contact, such as someone touching the handle of a hot metal skillet.
thermal conduction
the heat transfer mechanism in which no medium is required. refers to the movement of heat in waves, as it does not need molecules to travel through. the object need not be in direct contact with one another to transmit heat.
radiation (conversion)
a type of heat transfer that can only happen in liquids and gases, bc it involves those liquids or gases physically moving.
convection
When does convection happen?
when there is a different in temperature btwn 2 parts of a liquid or gas. the hot part of a fluid rises and the cooler part sinks.
means of delivering moist, superficial heat to the patient. filled with silicone gel and kept in tank of H20 at 170 degrees.
hot packs
cold is indicated in the acute stage of injury as well as for the prevention of swelling after exercise.
cold/ice packs
Name 3 effects of hot packs.
- increase blood flow
- increase extensibility
- decrease muscle spasms
Which stage of injury are cold packs used for?
acute stage of injury
What are cold packs used to prevent?
swelling after exercise
Name 2 contraindications of hot packs.
- acute inflammation
- acute injury - could increase edema
mixed with oil at a ratio of 7:1 and kept at 125 degrees. has a low specific heat, so it is UNABLE to deliver as much heat per gram as H20, therefore it feels cooler at a higher temperature.
paraffin
Name the 4 essential steps to do immediately after injury.
RICE Rest Ice Compress Elevate
immersion of body segment into cold then warm water alternately.
contrast baths
- good for later in treatment
- never put it directly on skin
ice/cold packs
Name 4 contraindications of cold packs.
- cardiac issues
- respiratory issues
- circulatory issues
- nerve injuries
- heat modality
- helps with joint stiffness
paraffin
Name 4 contraindications of parrafin.
- acute injury
- open wound
- infection
- loss of heat sensation
Name 1 contraindication for contrast baths.
-circulatory problems
a dry heat in which heat is transferred to the UE by swirling mixture of air and small particles at a temperature of 118 degrees.
fluidotherapy
- heating by convection
- dry heat transfer to UE
- OT can regulate temp and airflow
- pts. like it bc they can move and get the heat.
- can tone down the air.
fluidotherapy
Name 2 contraindications of fluidotherapy.
- vascular disease
- anesthetic (can’t feel proper sensation)
swirling warm water in metal tank which come in a variety of sizes for different body parts. usually cleansing agent in water, best for wound healing.
whirpool
- good wound healing characteristics
- swirling warm water
- not used a lot anymore
whirpool
electrical energy is converted into acoustic energy
ultrasound
-increases collagen sensibility and blood flow but could also increase inflammation
ultrasound
for the conservative management of acute or chronic pain, used for pain management
TENS
uses a current and blocks sensation
Gate control theory (TENS)
Name the 2 theories involved with TENS.
- Gate control theory
- Endorphin theory
stimulates one’s own pain regulators which take over when machine stops.
Endorphin theory
an electric current that can be used for: muscle strengthening, muscle re-eductation, ROM exercises, orthotic substitution
NMES
mechanical device that applies continuous reciprocal passive joint motion. control range, rate and force of movement.
Continuous Passive ROM (CPM)
Name 4 thermal modalities by CONDUCTION.
- hot packs
- cold/ice packs
- paraffin
- contrast baths
Name 2 thermal modalities by CONVECTION.
- fluidotherapy
- whirlpool
Name 1 thermal modalities by conversion.
-ultrasound
Name 3 electrical modalities.
- TENS
- NMES
- CPM
