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Introduction To Physical Agents

Physical agents include heat, cold, water, pressure, sound, electromagnetic radiation, and electrical current which are used in rehabilitation to assist patients. Thermal agents increase or decrease tissue temperature to affect circulation, metabolism, and pain. Mechanical agents apply pressure through traction, compression, or water. Electromagnetic agents use ultraviolet radiation, infrared radiation, or electric currents. Physical agents are primarily used to reduce inflammation, increase healing, modulate pain, and improve tissue extensibility, and are usually applied in conjunction with other rehabilitation interventions like exercise.

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Cyril Jay G. Ortega
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69 views25 pages

Introduction To Physical Agents

Physical agents include heat, cold, water, pressure, sound, electromagnetic radiation, and electrical current which are used in rehabilitation to assist patients. Thermal agents increase or decrease tissue temperature to affect circulation, metabolism, and pain. Mechanical agents apply pressure through traction, compression, or water. Electromagnetic agents use ultraviolet radiation, infrared radiation, or electric currents. Physical agents are primarily used to reduce inflammation, increase healing, modulate pain, and improve tissue extensibility, and are usually applied in conjunction with other rehabilitation interventions like exercise.

Uploaded by

Cyril Jay G. Ortega
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We take content rights seriously. If you suspect this is your content, claim it here.
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THE PHYSIOLOGY OF PHYSICAL

AGENTS

Asst. Prof. Claire A. Salera, PTRP, MPH


Physical Agents
● Various forms and means of applying
energy and materials to patients…to assist
in rehabilitation
● Includes heat, cold, water, pressure,
sound, electromagnetic radiation, and
electrical current.
● The terms “physical modality”, “modality”,
and “physical agents” are used
interchangeably.
Categories of Physical Agents
Category Types Examples

Thermal Deep-heating Diathermy


Superficial heating Hot pack
Cooling agents Ice pack
Mechanical Traction Mechanical
Compression Elastic bandage
Water Whirlpool
Sound Ultrasound
Electromagnetic Electromagenetic Ultraviolet rays
fields
Electric currents TENS
Thermal Agents
● Transfer energy to a patient to produce
an increase or decrease in tissue
temperature.
● Different thermal agents produce
greatest change in temperature in
different types and areas of tissue.
● Heat agents increase circulation,
metabolic rate, soft tissue extensibility,
and decrease pain….thermotherapy
● Cold agents decrease circulation,
metabolic rate and pain…cryotherapy
Mechanical Agents
● Apply mechanical force to increase
or decrease pressure in the body.
● Water provides resistance, increase
hydrostatic pressure, bouyancy – to
decrease pressure on weight
bearing structures.
● Traction decreases the pressure
between structures.
● Compression increases the pressure
between structures.
Electromagnetic Agents
● Apply energy in the form of electromagnetic
radiation or electric current.
● Ultraviolet radiation produces erythema and
tanning of the skin but does not produce heat.
● Infrared radiation produces heat in superficial
tissues.
● Electric currents produces sensory and motor
responses.
HISTORY OF THE USE OF PHYSICAL AGENTS
IN MEDICINE AND REHABILITATION

○ Bath houses with steam rooms and pools of hot


and cold water can be seen in major cities of the
ancient romans and greeks

● Heat and water - musculoskeletal and respiratory


problems
● Soaking and exercising in water - strength and
endurance, buoyancy, reducing weight bearing on
compression-sensitive joints
● Electrical Torpedo fish – apply electric shocks to the
head and feet to treat headaches and arthritis
● Amber – generate static electricity for the treatment
of skin diseases, inflammation, and hemorrhage
● Charged gold leaf – used to prevent scarring from
smallpox lesions
○ Before the widespread availability of antibiotics,
effective analgesics, & anti-inflammatory drugs,
physical agents were commonly used to treat:
● Infection
● Pain
● inflammation
THE ROLE OF PHYSICAL
AGENTS IN REHABILITATION

APTA Position Statement:
❖ “Without documentation which justifies the
necessity of the exclusive use of physical agents/
modalities, the use of physical agents/
modalities, in the absence of other skilled
therapeutic or educational intervention, should
not be considered physical therapy.”
❖ Physical agents should be applied in
conjunction with other interventions to facilitate
progress toward the functional goals of
treatment.
PHYSICAL AGENTS:
Are used primarily to reduce or eliminate soft
tissue inflammation or circulatory dysfunction,
increase the healing rate for soft tissue injury,
modulate pain, modify tone, increase
connective tissue extensibility & length,
remodel scar tissue, or treat skin conditions
○ Frequently used in conjunction with, or in
preparation for, other interventions such as
therapeutic exercise, functional training, or
manual mobilization in order to increase the
efficacy of these interventions.
Effects of Physical Agents

• Modify Inflammation and Healing


- The result is accelerated healing and reduce
the adverse effects of prolonged inflammation,
pain, and disuse.
Relieve pain
- physical agents modify pain perception or by
changing the underlying process causing the
sensation.
• Alter collagen extensibility
-Collagen is the main supportive protein
of skin, tendon , cartilage, and connective
tissue.
- Collagen extensibility is temperature
dependent, increasing in response to
increased temperature.
- heat agents usually applied before soft
tissue stretching to optimize the
stretching process.
• Modify muscle tone
- Muscle tone is a tension that serves as
a background for muscle contraction.
- Heat modalities decrease muscle tone.
INFLAMMATION & HEALING
○ Inflammation is the 1st phase of healing
○ Thermal agents modify inflammation & healing;
assist by reducing circulation, pain, enzyme
activity rate, controlling motion, promoting
progression to the proliferation phase
○ Lasts for 1 to 6 days
Proliferation Phase
○ Generally starts within the 1st 3 days after injury and
last for ~ 20 days
○ Collagen is deposited in the damaged area

○ Myofibroblasts contract to accelerate closure

○ Epithelial cells migrate to resurface the wound

○ Assist in promoting collagen deposition and progression


to remodelling phase
Maturation Phase
○ Usually starts within 9 days and can last up to 2 yrs

○ Deposition and resorption of collagen occurs

○ Healing tissue changes in both shape and structure

○ Physical agents assist by altering the balance of


collagen deposition and resorption; improving the
collagen fiber alignment
PAIN
● Unpleasant sensory and emotional
experience.
● Serves as a warning to protect the body
from damage.
● The activation of receptors of noxious
stimuli, known as “nociceptors.”
● The most common symptom prompting
patients to seek medical attention.
● The goals of treatment include resolving the
underlying pathology causing the pain;
modifying the perception of pain; and
maximizing function within the limitations
caused by pain.
● Acute pain – cryotherapy, TENS

● Chronicpain- resolution of
underlying pathology

● Referredpain – from the internal


organ to musculoskeletal area
● Pain
caused by malignancy – care
must be taken to prevent
metastasis

● Complex regional pain syndrome –


pain believed to involve
overactivation of the sympathetic
NS
General contraindication and precautions:
1. Pregnancy
2. Malignancy
3. Pacemaker
4. Impaired sensation
5. Impaired mentation
…end of Chapters 1 & 2

Thank you for not sleeping!

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