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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
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INTRODUCTION TO PHYSICAL AGENTS (AKA 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.
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 History of Modalities
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
THERMAL 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) THERMAL 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
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
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