Introduction to Physical Agents

Precautions for Physical Agents

impaired sensation old age pregnancy unconscious young age

Contraindications for Physical Agents

active deep vein thrombosis cancer fever electronic implants hemorrhagic conditions

Components for Documentation

modality body region patient position parameters rationale

True or False - Can electrical stimulation be used at home?

yes but with caution

True or False - Can shortwave diathermy be used at home?

no

True or False - Can traction be used at home?

yes but only manually

Electrical Stimulation utilizes electrical current in order to…

muscle contraction changes in sensation edema reduction tissue healing

True or False - Shorter Wavelengths induce higher frequency of oscillations

true

Physical Modalities that Utilize Electromagnetic Waves

ultraviolet radiation diathermy LASER infrared radiation

Mechanical Agents

water - hydrotherapy mechanical traction - intermittent cervical traction or intermittent lumbar traction compression - intermittent pneumatic compression pressure - extracorporeal shockwave therapy sound - ultrasound

Reverse Piezoelectric Effect

applying an electrical voltage to a material causes it to mechanically deform

Direct Piezoelectric Effect

converts mechanical energy to electrical

Methods of Heat Energy Transfer

conduction convection evaporation conversion

Conduction Method

hot moist pack paraffin wax bath ice or cold pack

Convection Method

cold whirpool fluidotherapy

Evaporation Method

vapocoolant spray

Conversion Method

ultrasound diathermy

Types of Physical Modalities

thermal (temperature) electromagnetic (energy) mechanical (load)

Inflammation Phase

injury inflammation phase vasoconstriction vasodilation clot formation phagocytosis

Proliferation Phase

epithelialization (re-covering the wound) fibroplasia wound contracture neovascularization

Maturation Phase

collagen synthesis / lysis balance collagen fiber orientation healed injury

Tissue Healing

hemostasis > inflammation > proliferation > maturation

Inflammation (Time)

4 - 6 days

Proliferation (Time)

4 - 24 days

Remodelling (Time)

21 days - 2 years

Alteration of Muscle Activation

facilitation (depolarization of peripheral nerves to recruit more motor units) inhibition (decrease motor nerve conduction or synaptic activity)

Neurons (Fibers)

both are unipolar

Diameter (Fibers)

A-Delta: small C: smallest

Myelination (Fibers)

A-Delta: myelinated C: unmyelinated

Transmission of Action Potential (Fibers)

A-Delta: 30 m/s C: 1-4 m/s

Pain Transmitted (Fibers)

A-Delta: sharp

Description (Fibers)

A-Delta: local C: diffusely local

Pain is modulated by endogenous opioid-like peptides called…

opiopeptins endorphins

Clinical Applications of Physical Agents

pain modulation alteration of muscle activation decreasing inflammation and facilitation of tissue healing increasing tissue extensibility

Explain the Gate Control Theory

The theory proposes the existence of a "gate" in the dorsal horn of the spinal cord