What is a physical agent (modality)?
Various forms of energy and materials applied to patients to assist in their rehabilitation
3 Categories of Modalities
1) Thermal
2) Mechanical
3) Electromagnetic
What do thermal agent do?
Transfer energy to produce an increase or decrease in tissue temperature (superficially or deep)
Examples of Thermal Agents
- Hot pack
- Diathermy
- Ice pack
- Ice Massage
What do mechanical agents do?
Apply mechanical force to increase or decrease pressure in or on the body
4 categories of mechanical agents
- Traction – decreases pressure between structures
- Compression – increases pressure
- Water – provides resistance, hydrostatic pressure
- Sound – uses alternating waves of compression and rarefaction
Examples of Mechanical Agents
- Traction
- Game Ready
- Stockings
- Hydrotherapy
- Ultrasound
- Phonophoresis
What do electromagnetic agents do?
Apply electromagnetic energy in the form of electromagnetic radiation or an electrical current
Electromagnetic energy vs. Electrical Currents
- Electromagnetic energy vary the frequency and intensity to produce desired treatment effects
- Electrical Currents vary waveform, intensity, duration and direction of current flow to produce desired treatment effects
Examples of Electromagnetic Agents
- UV
- TENS
- Laser
- IFC
- Russian
- Premod
According to the APTA the ______ use of modalities is not considered PT
exclusive
5 Components of the Disablement Model
1) Pathology
2) Impairment
3) Functional Limitation
4) Disability
5) Handicap
The effects of physical agents are primarily at what level?
Impairment
Effects of Physical Agents
- Reduce or eliminate soft tissue inflammation
- Reduce or eliminate circulatory dysfunction
- Modify the healing rate for soft tissue injury
- Modulate pain
- Modify tone
- Alter collagen extensibility
- Remodel scar tissue
- Treat skin conditions
3 Phases of Inflammation and Healing
1) Inflammatory Phase
2) Proliferation Phase
3) Remodeling (Maturation) Phase
How long is the inflammatory phase?
1-6 days
During the inflammatory phase what are the goals of modalities used?
- Assist in reducing circulation
- Reducing pain
- Reducing the enzyme activity rate
- Controlling motion
- Promoting progression to the proliferation phase of healing
When does the proliferation phase begin? How long can it last?
Starts within the first 3 days after injury
Can last up to 20 days
During the inflammatory phase what are the goals of modalities used?
- Increasing circulation
- Increasing the enzyme activity rate
- Promoting collagen deposition and progression to the remodeling/maturation phase of healing
When does the remodeling phase begin? How long can it last?
Starts approximately 9 days after the initial injury
Can last for up to 2 years
During the inflammatory phase what are the goals of modalities used?
- altering the balance of collagen deposition and resorption
- improving the alignment of new collagen fibers
What are Contraindications?
conditions that render a particular form of treatment improper
What are precautions?
conditions under which a form of treatment should be applied with special care and limitations
When choosing a physical agent what are the steps/things you should consider?
1) Determine the goals and effects of treatment
2) What are the contraindications and precautions?
3) What is the evidence for physical agent use?
4) What is the cost, convenience and availability?
5) What are the patient and clinician comfortable with?
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Intro to Physical Agents24
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Electromagnetic Radiation32
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Inflammation and Tissue Repair57
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Aquatic Therapy34
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Mechanisms of Pain42
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Tone Abnormalities44
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Motion Restrictions6
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Thermal Agents57
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Thermal Agents (part 2)15
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Ultrasound71
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Diathermy39
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Lasers40
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Ultraviolet Radiation22
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Traction42
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Hydrotherapy40
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Compression54
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Massage Therapy41
