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Heat-internal vibration of molecules within the body. Conduction-heat lost or gained by direct contact Convection-movement through air or H2O tranfers heat to our body Radiation-transfer of heat from warmer source to cooler one Evaporation-transfer from liquid to gas state

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heat internal vibration of molecules within the body
Heat-internal vibration of molecules within the body
  • Conduction-heat lost or gained by direct contact
  • Convection-movement through air or H2O tranfers heat to our body
  • Radiation-transfer of heat from warmer source to cooler one
  • Evaporation-transfer from liquid to gas state
  • Superficial heat-HP,W/P paraffin
  • Deep heat-diathermy, ultra sound
Thermotherapy-heat modalities, used when goal is to increase temperature
  • Cryotherapy-cold modalities
  • Hydrotherapy-H2O is used as medium to increase or decrease tissue temp.
  • Heat:
    • produces analgesic affect
    • promotes ms. Relaxation
    • increases elasticity
    • decreases viscocity of C.T.
    • Increases local metabolism of A’s and caps
    • inc. blood flow to body part treated, inc. edema
    • inc. Leukocytes and phagocytosis
Examples of superficial heat<1cm.
  • Hot packs
    • moist heat-stored in hydrocollator units -165 F
    • 6-8 layers for insulation
    • towel for perspiration
    • consider body part treated, position of pt., weight of HP
    • Cervical, lumbar, small and large
    • describe to pt. what to expect
  • Paraffin
    • 1 cm. Mineral oil and wax (5# wax/1 part oil) temp. 125 F,retains perspiration and softens skin
Good for distal parts of extremities
  • Methods
    • Glove-dip 8-10 times, bag, towel, elevate, treatment time 20 min. return wax to unit
    • Immersion-dip once to coat, then immerse remainder of time, temp. Increase is greater than glove-edema may result
    • Advantages
      • Conforms to body part treated
    • Disadvantages
      • can’t use with open wound
    • Fluidotherapy
      • dry, warm air is circulated
      • can use with splints,other things to enhance tx.
Contraindications for heat
    • acute inflammation,fever, malignancies, acute hemorrhage, PVD, overradiated pt, cardiac insufficiency, unexplained pain, acute infection coma, int bleed; precautions-impaired circulation, pregnancy, older adults and children<4 yo
    • Precautions: previous existing edema, sensory loss, confused patients
Cryotherapy-use of cold-goal it to decrease tiss temp, it dec metabolism, causes vasocon, dec bl flow, nerve ms excitability, ms spindle activity, edema and promotes analgesia
  • Ice-silica gel in frig, cold W/P, ice w/p, massage, cold spray, contrast baths, normal cold progression-cold, stinging, burning, numbness

Indications-spasticity, acute inf, ms spasm, edema

  • Raynaud’s disease, cardiac dysfunction open wounds after 48-72 hours, arterial insufficiency, cold urticaria
contrast baths
Contrast Baths

-two containers with warm/cool water

-warm 80-104 degrees F

-cool 55-67

-Immerse in warm 3-4 min, then cool 1 min.

-Repeat 5-6 times

-Always finish with warm

-used for chronic edema, infl. conditions, hypersensitization

Hydrotherapy-Archimedes principle-an immersed object exerts an upward thrust = wt. Of H2O displaced (buoyancy)
  • viscocity-resistance to flow
  • W/P source of moist heat
  • hydrostatic pressure-exerted agst skin
  • Pascal’s law- fluid exerts = pressure on all surfaces of a body at rest which increases in proportion to depth
  • Conduction and convection
  • Get inc rate of lymph flow, local met inc., perspiration inc, debridement, vasodiation, ms relax, inc cell perm and assist or resis with ROM
  • Increases hydrostatic pressure which may increase lymph circulation
  • Graded exercise (with or against turbulence
  • Debrides necrotic tissue therefore decreasing bacterial load

Stage III and IV wounds

Subacute and chronic inflammatory conditions

Early PVD

Peripheral nerve injuried

Muscle weakness

  • Same as those for heat
  • Venous ulcers
Very hot-104-110


Mild Warm-96-98




Soft tissue extens, chronic


Burn patients

Open wounds, circ, sensory, cardiac disorder, decrease tone

Exercise, acute inflam (if not able to tol cold)

Acute inflammation

aquatic therapy
Aquatic therapy
  • Same principles apply
  • Water temp-79-97 degrees F
    • 93-97 for light exercise by elderly deconditoned
    • 79-83 for more intense exercise and recreational pools
    • Should not go below 65 F (may impair ms. contract)
  • % of WB with depth immersion:
    • C7-8%
    • Xiphoid-28%
    • ASIS-47%
  • Ease of movement, weightlessness
  • Progressive WB
  • Can facilitate, support or resist mvmt
  • Ease of pt handling
  • Total body mvmt
  • Easy to progress program
  • Can perform many types of exercise
laws for dosage of em radiation
Laws for dosage of EM radiation
  • Cosine law-absorption of ray is optimal when it strikes the surface at the perpendicular
  • Inverse square law-Intensity of radiation at any distance is inversely proportional to the square of the distance b/w the sure face and the source of radiation
  • Arndt-Schultz law-a certain minimum stimulus is needed to initiate a biological process
  • To heat through (3-5 cm.)
  • Converts hi fx electromag E to heat in tissues
  • Frequency 27.12 MHz
  • Contraindications
    • General for heat
    • Pacemakers
    • Metal implants
    • Epiphyses
    • Eyes, testes, malignancy, pregnancy
  • Pool cost/ maintenance and upkeep
  • Time in commuting/changing
  • Limited carryover
  • Additional risk
  • Bowel/bladder incontinence
  • Open wounds
  • Infectious disease
  • Seizures
  • Tracheotomy tubes
  • Severe cardiovascular disease
  • Orthopedic instability
Induction field-places pt in the EM field produced by the equipment ; current is induced in conductive tissues-heats superficial ms., heat is produced in deeper ms. from overlying ms. (drums or induction coil)
  • Condensor field (capacitance)- pt. is placed b/w 2 e’s in the electrical circuit (air spaced plates)
radiant heat
Radiant Heat
  • Infrared and ultraviolet
  • Infrared-form of radiant heat which emits infrared waves (outside visible spectrum)
  • 2 types-
  • Luminous-emits short infrared waves
  • Non-luminous-emits long infrared waves
  • Indications-seeping wounds,chronic conditions
  • Contra-same for heat
  • Causes a chemical change in tissues
  • Both UV and infrared possess these characteristics
  • Direction of travel is in straight line that can be reflected, refracted, absorbed or passed through depending on the medium they strike
Light is characterized by:
  • Wavelength-measured in nanometers
  • Visible-b/w 400-800 nm
  • UV light-180-400
  • Infrared-800-1500
  • Frequency-# of oscillations or vibrations in 1 second-expressed in hertz
  • The higher the frequency, the shorter the wavelength
UVA-320-400 nm.-penetrates furthest (into dermis)
  • UVB-290-320-psoriasis
  • UVC-<290, cold quartz-operates at low temps. Used to promote bacteriocidal effects, wound debridement, tissue regeneration
  • UV is used to promote erythemal response w/in 12 hours of exposure-causes chemical reaction that impacts on the immune system
  • -pressure sores, acne, wound care, psoriasis, to decrease bacteria in pressure sores (especially after pulsed lavage)
  • Contraindications
  • -photosensitivity, cancer, systemic lupus errythmatosis, cardiac, kidney or liver disease active TB, fever, acute diabetes, drugs, direct eye contact
  • Photosensitivity as a result of drugs
  • Drugs such as gold salts, psoralens, tetracyclines
  • Syphilis
  • Alcohol
  • Elevated levels of estrogen
  • Foods such as shellfish, strawberries
Must establish MED-exposure time necessary to produce mild erythemal dose-lasts to 48 hours
  • SED-no erythema
  • MED-smallest dose producing erythema
  • Appears 1-6 hrs, fades in 24
  • Goggles
  • Place body part perpedicular
  • Protect skin not treated
  • Use same lamp
  • Cover genitals, nipples
  • Place lamp 24-36 inches away
  • Use test strip to test-uncover each hole so 1st hole will have greatest exposure
  • Cut six holes with different shapes
  • Use skin not exposed to uv light
  • Remove clothing, jewelry, wash area
  • Attach MED strip and cover with towel
  • Position lamp perpend to treated surface
  • 30 sec hole 1,2. 15 sec. 3-6
Instruct pt. to check arm in bright area every 2 hrs. and document which symbols appear and fade
  • Dosage time should be increased by 25% next treatment as long as effects of previous dose have disappeared
  • EM E within visible spectrum
  • Low level laser therapy
  • Used for tissue healing and pain management
  • Contraindicated for pregnant women, unclosed fontanelles of children, cancerous lesions, cornea, endocrine glands and hemorrhaging lesions