intro physical agents slides

What are physical agents/modalities considered? What should they be used with?

They are passive treatments that should be used with active treatments.

Define physical agents.

The application of energy in some form to the human body to produce a thermal or physical effect.

What physiological effects could modalities have?

• Dec. pain perception

• Control inflammation

• Inc. circulation

• Reduce muscle tone

• Fascilitate muscle contraction

• Dec. joint effusion/soft-tissue swelling

• inc. metabolic activity (promote tissue healing)

Describe the 3 categories of physical agents.

• Thermal: ice, hot pack, paraffin, laser, fluid therapy

• Mechanical: Traction, intermittent compression

• Electromagnetic: electric stimulation, diathermy, iontophoresis

What are the 5 cardinal signs of inflammation?

• Heat (calor)

• Pain (dolor)

• Swelling (Tumor)

• Redness (Rubor)

• All these lead to loss of function

What are goals with modalities during inflammatory phase of healing? What modalities might be used?

Goals: Control inflammation, swelling, pain (cryotherapy after 2-3 days).

Mods: iontophoresis, phonophoresis, sensory-level E-stim (goal of gaiting pain), light compression/wrap

What are goals with modalities during proliferation phase? What modalities are usually used?

Goals: Prevent scar tissue formation, promote tissue healing.

Mods: Pulsed US, Pulsed diathermy, laser/light, low level motor e-stim, moderate compression. Often start tx w/ thermotherapy (loosen tissues) but end with cryotherapy (pain control)

What are goals with modalities during maturation phase? What mods are usually used?

Goals: Restore function, restore ROM, flexibility, promote scar tissue remodeling

Mods: Thermotherapy, continuous US, diathermy, motor-level e-stim

Describe mechanical pain, and how to treat it.

Mechanical pain is usually from compression, tension, or pressure on tissue that activates nociceptors

Movement-based pain so movement-based intervention

Tx: unload tissue (NSB, brace/splint, movement), reduce swelling (hydrostatic pressure), grade I and II mobs

Describe chemical pain, and how to treat it.

Chemical pain is from histamine, prostaglandins, kinins that activate nociceptors.

Chemical based pain so chemical based intervention

Tx: Dec. tissue temp (ice) → dec. metabolic activity, meds that interfere w/ inflammation (iontophoresis, phonophoresis, NSAIDS)

What does the PEACE & LOVE acronym stand for? What is the general goal of the PEACE vs the LOVE part?

PEACE: Minimize pain

Protection, Elevation, Avoid anti-inflammatories, Compression, Education

LOVE: optimize movement

Load, Optimism, Vascularisation, Exercise

List the 5 methods of energy transfer and describe each shortly.

Conduction: physical contact (hot/cold pack)

Convection: Current crosses an area (air or water) and causes temp change

Conversion: Changing from one type of NrG to a different type (US)

Radiation: Heat source, medium in between, warmth from heat source

Evaporation: Changing from liquid to gas.

Define and describe specific heat.

Definition: amount of NrG needed to raise temp of a given mass (1g) by a number of degrees (1 deg C)

water has a higher specific heat than air, so you would burn quicker in 130 F water than 130 F air, since water would transfer it’s heat to you more effectively, and would also retain it’s temp better than air would since it requires more NrG to change it’s temperature.

Define conduction. Where does heat transfer from and to? Give examples of this.

Conduction is transfer of heat from one material to another that are in direct contact with each other.

Heat transfers from higher temp → lower temp.

ex: Hot pack → pt ; paraffin → pt

Pt → cold pack

Pt → ice massage

Describe the parameters of heat transfer. What aspects inc. speed of heat transfer?

Higher temp, larger area of contact/availability, and greater temp difference → faster heat transfer.

What are examples of conduction?

Hot pack, paraffin, cold pack, ice massage, cryo cuff, ice bath

What are examples of conversion?

Diathermy, Ultrasound

What are examples of radiation heat transfer?

Infrared lamp, laser, UV light

What are examples of evaporation heat transfer?

Vapocoolant spray

What are examples of convection heat transfer?

Whirlpool, fluidotherapy