PHYSICAL AGENTS

Trans by: L.N Reyes

THERMOTHERAPY

 Hot moist pack (Hydrocollator packs) –

provides superficial moist heat to slightly
deeper tissue

General Indications:
 Before Active Exercise – produces analgesic
effect
 Before PROME – increase in tissue
extensibility
 Before ES – increase sweating – decrease
resistance
 Before Traction – reduce muscle tension,
promote muscle relaxation
 Before Massage – promote muscle
relaxation
 Presence of mm spasm – decrease pain
 Before ultrasound – increase in tissue
extensibility
 Before PJM – decrease pain; promote mm
relaxation
 Use in with other techniques – to achieve
relaxation and sedation
 When moist heat is comfortable for patient

Precautions:
 Don’t allow the patient to fall asleep or lie on Dangers:
the pack; if unavoidable place several layers  Dehydration
in between  Burn (if no longer blanchable)
 Explain the amount of heat that he should
receive and inform you if additional travels
are needed
 Determine if the patient can tolerate HMP
weight
 Know that the heat is significant on
superficial structures (1-2 cm)

COLD THERAPY
 Used as a first aid measure after trauma and
as an adjunctive tool in the rehabilitation of
musculoskeletal and neuromuscular
General Contraindications: dysfunction
 If injury is at stage where edema or bleeding
may still be present – increase blood flow
PHYSICAL AGENTS
Trans by: L.N Reyes
 Heat is removed or lost from an object in
referred to as heat abstraction or cooling
 Therapeutic use of cold
o In rehabilitation, mild cooling -> to
control inflammation, pain, and
edema to reduce spasticity, to control
symptoms of Multiple Sclerosis, to
facilitate movement
o Outside rehabilitation, for
destruction of malignant and non-
malignant tissue growth (freeze and
destroy)

Precautions:
Indications:  Over the superficial main of nerve
 Inflammation control  Over an open wound
 Edema control  Hypertension and unstable cardiac conditions
 Pain control  Poor sensation/mentation
 Modification of spasticity  Very young and very old patient
 Symptom management in MS
 Facilitation of movement
 Immediate intervention for small burns
 Cryokinetic – cold + exercise
 Cryostretch – cooling before stretching, to
reduce mm spasm
 RICE
o Rest Adverse effects of Cryotherapy:
o Ice  Tissue death
o Compression  Tissue damage
 Frostbite
o Elevation
 Temporary or permanent nerve damage
 Reflex vasodilation

Normal Effects of Cryotherapy (CBAN)

 Cold
 Burning
 Analgesia
 Numbness

PARAFFIN WAX BATH

Advantages:
 Allows application at a higher temp
Characteristics:
 Allows heating of tissues to occur move
 Low slowly
thermal conductivity (slowly, retain
heat)
 Allows even distribution of heat
 Low melting pointskin
 Moisturizes (54 °c or 129°F)
Contraindication:  Low specific heat
 Reduces (0.5) – can of
the probability be burn
directly
 Cold hypersensitivity (cold-induced urticaria) applied
 Wax to can
skinbe used as exercise material
 Cold intolerance  Gives comfortable heat
 Cryoglobulimea  Can treat multiple patient at the same time
 Paroxysmal cold hemoglobinuria  Can be carried at home
PHYSICAL AGENTS
Trans by: L.N Reyes
 Self-insulating – 8 layers of wax (1st
layer/insulation)

Physiologic Response:
 Circulatory effect (vasodilation)
 Analgesic effect (inc blood flow = no
prostaglandins substance P) washes pain Disadvantages:
metabolites  Sedimentation occurs at the bottom and
 Tissue extensibility (relaxes tissue, muscle, emptied twice a year
fibers)  Needs to be cleaned regularly and emptied
twice a year
Heat production:  Accumulate atmospheric dust
 Skin: inc by 12-13°c (first 2 mins)  Water tend to collect at the bottom of the
 Skin: maintained at 8°c; inc for 30 mins tank
 Subcutaneous fascia: inc 5°c at the end of tx  Difficult to apply on proximal portion of the
body
 Superficial muscle: Inc of 2°c – 3°c at the
 Can be messy
end of tx
 Passive treatment

Indications:
 Pain and muscle spasm
 Edema (mild) and inflammation (chronic; Things to do before applying:
RA)  Ratio
 Adhesions and scars  Explain the sensation to be felt
 Explain dangers and precaution
 TEST and INSPECT skin
 WASH and DRY px hand
Contraindication:  Remove Jewelry
 Impaired skin sensation  Check Paraffin Temp
 Dermatologic condition
 Circulatory dysfunction
 Analgesic drugs
 Infections and open wounds
 CA and TB
 Gross edema – generalized edema (Anasarca)
 Lack of compressions
 Deep X-ray therapy
 Liniments (painkillers; pau)
PHYSICAL AGENTS
Trans by: L.N Reyes

INFRARED RADIATION

Indication:
 Pain and mm spasm
 Edema
 Joint stiffness
Dangers:
 Increasing circulation
 Dehydration
 Tissue/wound healing (ulcers)
 Acute burns
 Various forms of arthritides (OA, RA, PsA)
 Decrease sperm count
 Acute, subacute, and chronic catarrhal
 Optical Damage
conditions particularly in episiotomy
 Apnea in children
 Preliminary heating modality before exercise
or ES

Contraindication:
Precaution:  Impaired skin sensation
 Don’t sleep  Impaired circulation
 Don’t read books  Dermatological condition
 Don’t look inside/at the lamp  Eyes
 Don’t move the lamp  Age
PHYSICAL AGENTS
Trans by: L.N Reyes

ULTRASOUND

Indication: Contraindications:
 Chronic system peripheral arterial disease  Cardiac problems
o PVD – often causes pain in the leg  Pregnancy
o Arteriosclerosis obliterans  Tumor
o AI of the legs  Thrombophlebitis
o Intermittent claudication  Infected Areas
 Open wounds
 Plantar Warts
 Sympathetic NVS d/o
Precautions:
 Neuroma (pinched nerve)
[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[[  Osteoporosis
 Muscular problems
 Primary repair of tendon/ligament
 Periarticular Conditions
 Unhealed fracture sites
o Usually inflammation
 Metal implants
o Bursitis, Tendinitis, Epicondylitis,
 Plastic implants
Fasciitis, Tendosynovitis
 Chronic Arthritis (RA,OA)
 Contracture
o Joint capsule/Adhesive scans
o Dupuytren’s contracture Dangers:
o Fibrous plaque in pyronines disease  Shocks
o Reducing curvature of penis  Burns