INTRODUCTION TO PHYSICAL AGENTS
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Transcript of INTRODUCTION TO PHYSICAL AGENTS
INTRODUCTION TO PHYSICAL AGENTS
(AKA Modalities)
What are physical agents or modalities?
What are physical agents or modalities?
Various forms of energy and material applied to a patient to achieved a goal by the means of their application
Include heat, cold, water, pressure, sound, electromagnetic radiation, and electrical currents.
History of Modalities• Ancient Rome and
Greece used heat and water (steam rooms, hot & cool pools) to treat ailments
• Late 19th Century Europe – natural hot springs
• 400 B.C. Torpedo fish were used to apply electrical shock
• Sunlight was used to treat TB, bone & joint diseases, dermatological problems & infection
• Over time new uses and techniques have developed due to better understanding of the body, disease,and recovery. Also practice has change with the development of new technology.
• Modalities is a constantly changing area of practice due to a variety of reasons.
It is not a black and white area of study
Definition Review (page 18 & 19)
• Impairment• Functional Limitations• Pathology• Disability
ROLE OF MODALITIES IN REHAB
The days of “shake & bake” are long gone in rehab.
Modalities alone DO NOT constitute a skilled treatment
Modalities should be used in conjunction with other therapeutic techniques to reach an established goal of rehab.
(see APTA statement on page 5)
Categories of Physical Agents
Table 1-1, pg 2
Category Types Clinical Examples
Thermal Deep Heating Agents Ultrasound, Diathermy
Superficial Heating Agents
Hot Pack, Paraffin
Cooling Agents Ice Pack
Mechanical TractionCompression
Mechanical TractionElastic Bandage, Stocking
Water Whirlpool
Sound Ultrasound
Electromagnetic
Electromagnetic FieldsElectric Current
Ultraviolet, laserTENS, NMES, HVG
THERMAL AGENTSTHERMAL AGENTS –
transfer energy to a pt. to cause an increase or decrease in tissue temp.
Different agents will produce different changes in temp. (I.e. Deep heating agents, superficial agents, cooling agents)
Why use thermal agents?
• Increase circulation• Increase metabolic rate• Increase soft tissue extensibility• Decrease pain through sedation of
nerve endings
When cryotherapy (cold)is used you will see the opposite effect. Pain is decreased through numbing of the tissue.
MECHANICAL AGENTS
• These modalities apply a mechanical force to increase or decrease pressure on the body.
• Examples: Traction, compression, hydrotherapy (water), ultrasound
ELECTROMAGNETIC AGENTS
• Modalities that apply electromagnetic energy in the form of electromagnetic radiation, fields and electrical current
• Examples: electromagnetic fields, all types of E-stim
GENERAL EFFECTS of PHYSICAL AGENTS
• Inflammation & Healing – when used appropriately they can modify & promote healing by modifying the rates of circulation and chemical reactions associated with inflammation and healing.
Physical Agents for Tissue Healing
• The stage of tissue healing determines the goals of intervention and the physical agents used.
• Review Phases of Healing (page 9)
• Table 1-2, page 9
Physical Agents for Pain Modulation
• The choice of a physical agent for treating pain depends on the type of etiology of the pain.
• Table 1-3, page 11
Collagen Extensibility and Motion Restrictions
Physical Agents for the Treatment of Motion Restrictions• Physical agents can be effective
adjuncts to the treatment of motion restrictions caused by mm weakness, pain, sift tissue shortening, or a bony block.
• The appropriate interventions for each of these will vary.
• Table 1-4, page 13
Physical Agents for Tone Abnormalities
• Physical agents can temporarily modify muscle hypertrophy, hypotonicity, or fluctuating tone.
• Table 1-5, page 14
Consideration when using Physical Agents• Indications – situations that indicate or are
safe to use a modality.
• Contraindication (absolute) – conditions that render a particular Rx undesirable or improper (when not to use the modality)
• Precautions - conditions that require a particular Rx to be done with limitations or special care
• General CI’s & Precautions – pregnancy, malignancy, impaired sensation & mentation
General Contraindications and Precautions
• Pregnancy• Malignancy• Pacemaker or other implanted
electronic device• Impaired sensation• Impaired mentation
Choosing a Physical Agent (fig 1-2, p 8)
Fig 1-3, p 8
Evidence-Based Practice and Physical Agents
Terms to know (page 18-19)
• Clinical practice guidelines
• Contraindications• Disability• Electromagnetic
agents• Evidence-based
practice• Systemic Reviews
• Functional limitations
• Impairments• Indications• Mechanical agents• Pathology• Physical agents• Precautions• Rehabilitation• Thermal Agents