PTA 2 - Physical Agents (Heat, Cold, Pressure etc)

This is some Unit 1 topics in our first week back in the second semester (1st year) physical therapy program. For reference to last semester, we spent most of our time learning the history of PT, what kind of pathologies we will see, basics of documentation, and finally building comfort working with patients (our lab partners).  This semester will now focus on basic treatments, and applying them to our patients (partners).  Please follow along each week as I learn in preparation for tests, evaluations and my final 2 clinical rotations before graduation!

Physical agents are anything that can be applied to the body that creates a physiological change.  A related term is a modality.  Examples of physical agents include, heat, cold, water, pressure, sound, and electromagnetic stimulation.  Physical Agents are often considered a passive treatment and have direct effects primarily at the level of impairment, such as reducing pain that impairs limb function.

Thermal agents transfer energy to a patient to produce and increase or decrease in tissue temperature. Examples include hot packs, cold packs, whirlpools, and Ultra sounds.

Thermatherapy Physiological Changes:

• Increase circulation
• increase metabolic rate
• increase inflammation
• decrease pain
• decrease muscle spasm
• decrease tissue stiffness

Cryotherapy Physiological Changes:

• Decrease circulation
• decrease metabolic rate
• decrease inflammation
• decrease pain
• decrease muscle spasm
• increase tissue stiffness

Mechanical Agents is the application of force to increase or decrease pressure. Examples include hydrotherapy, traction, and compression.

General Contraindications and Precautions for Physical Agent Use:

Pregnancy due to negative influence on fetal development.

Malignancy due to alteration of circulation and can accelerate growth or metastasis

Pacemaker due to electric currents altering function

Impaired sensation due to patient unable to report how the treatment feels which may cause harm such as burns.

In terms of physical therapy practice physical agents should always be combined with other skilled interventions such as manual therapy, and therapeutic exercise for reimbursement purposes, since patients can typically use physical agents (hot and cold) with little education on their own.