INTRODUCTION TO
PHYSICAL AGENTS
Pamantasan ng Lungsod ng Maynila - College of Physical Therapy
Learning Outcomes:
1. Describe the different categories of physical agents
2. Enumerate the effects of physical agents
3. Enumerate the contraindications and precautions to use
4. Explain the following concepts related to heat:
a. Scales of measure
b. Factors that could affect temperature of object
c. Heat transmission
d. Type of transmission of heat used in a therapeutic modality
5. Explain the different effects of heat
6. Describe the difference of superficial & deeep heating modalities
Introduction to Physical Agents
Topic Outline: Physical principles of heat transmission
1. Categories of physical agents Heat transfer
2. Effects of physical agents Conduction
3. General contraindications & precautions Convection
for the use of physical agents Evaporation
Conversion
Heat Radiation
1. Scales of measurement for heat & Relation of heat transmission in
temperature therapeutic use of modalities
2. Factors that could affect the Physical effects of heat
temperature of an object Difference of superficial & deep heating
modalities
Introduction to Physical Agents
What are physical agents?
Introduction to Physical Agents
What are physical agents?
Forms of energy & materials applied to patients to assist in
rehabilitation
Includes:
Heat
Cold
Water
Pressure
Sound
Electromagnetic radiation
Electrical currents
Introduction to Physical Agents
Role of Modalities in Rehabilitation
Modalities alone do not constitute a skilled treatment.
Modalities should be used in conjuction woth other therapeutic
techniques to reaach an established goal of rehab. (APTA 1995,
2005)
Introduction to Physical Agents
Categories of Physical Agents
Thermal Agents
Deep-heating, superficial-heating, superficial cooling agents
Mechanical Agents
Traction, compression, water, sound
Electromagnetic Agents
Electromagnetic fields, electrical currents
Introduction to Physical Agents
Introduction to Physical Agents
Categories of Physical Agents
Thermal Agents
Transfer energy to a patient to produce an increase or decrease in
tissue temperature
Cryotherapy - therapeutic application of cold
Thermotherapy - therapeutic application of heat
Why use thermal agents?
Introduction to Physical Agents
Thermotherapy
Increases circulation
Increases metabolic rate
Increases soft tissue extensibility
Decrease pain through sedation of nerve endings
Cryotherapy
Decrease circulation
Decrease metabolic rate
Decrease pain through numbing of tissue
Introduction to Physical Agents
Categories of Physical Agents
Mechanical Agents
Apply force to increase or decrease pressure on body
Hydrotherapy - therapeutic use of water
Can provide resistance, hydrostatic pressure, & buoyancy
Traction - decreases pressure between structures
Compression - increases pressure on & between structures
Electromagnetic Agents
Apply energy in the form of electromagnetic radiation or an
electrical current
Introduction to Physical Agents
Effects of Physical Agents
General effects:
Modification of tissue inflammation & healing
By changing rates of circulation & chemical reactions
Healing
Phases of
Time Characteristics Physical Agents Work
Healing Frame
Cells that remove debris and limit bleeding Reducing circulation
enter the traumatized area Reducing pain
(+) cardinal signs of inflammation Reducing the enzyme
Inflammatory Rubor(redness) activity rate
1-6 days
Phase Calor(increased heat) Ccontrolling motion
Tumor (swelling) Promoting progression to
Dolor (pain) the proliferation phase of
Functiolaesa (loss of function) healing
Introduction to Physical Agents
Phases of Healing
Characteristics Physical Agents Work
Healing Time Frame
Collagen is deposited in the damaged
area to replace tissue that was Increasing circulation and the
destroyed by trauma enzyme activity rate
Proliferation First 3 days
Myofibroblasts contrac to accelerate Promoting collagen deposition
Phase to ~ 20 days
closure Progression to the remodeling
Epithelial cells migration and resurface phase of healing
the wound
Both deposition and resorption occurs
Remodelingof new tissue (similar with
old one) Altering the balance of collagen
Maturation 9 days up to Healing tissue changes in both shape deposition & resorption
Phase 2 years and structure to allow for optimal Improving the alignment of new
functional recovery collagen fibers
Greater strength is achieved with no
change in tissue mass
Introduction to Physical Agents
Introduction to Physical Agents
Effects of Physical Agents
General effects:
Relief of pain
By changing underlying process causing the sensation ->
modulating transmission at spinal cord level, changing rate of
nerve conduction, or altering the central or peripheral release of
neurotransmitters
Introduction to Physical Agents
Introduction to Physical Agents
Effects of Physical Agents
General effects:
Alteration of collagen extensibility
Extensibility of collagen increases in response to increased temperature
Introduction to Physical Agents
Effects of Physical Agents
General effects:
Modification of muscle tone
By altering nerve conduction, sensitivity, or biomechanical
properties of muscle, or indirectly by reducing pain or underlying
cause of pain
Introduction to Physical Agents
General Contraindications & Precautions
Considerations:
Indication - situations that indicate or are safe to use a modality
Contraindication (Absolute CI) - conditions under which a particular
treatment should not be applied
Precaution - conditions under which a particular form of treatment
should be applied with special care or limitations.
Introduction to Physical Agents
General Contraindications & Precautions
Pregnancy
Malignancy
Pacemaker or other implanted electronic device
Impaired sensation and mentation
Introduction to Physical Agents
Choosing a Physical Agent
Introduction to Physical Agents
