Physical Agents Theory and practice Laboratory Manual

235 Pages·2006·2.95 MB·English

by  Barbara J. Behrens

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Physical Agents
Theory and Practice
Laboratory Manual
Second Edition
Barbara J. Behrens, PTA, MS
Coordinator, Physical Therapist Assistant Program
Mercer County Community College
Trenton, New Jersey
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F. A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
Copyright © 2006 by F. A. Davis Company
All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a re-
trieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying,
recording, or otherwise, without written permission from the publisher.
Printed in the United States of America
Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1
Publisher:Margaret Biblis
Developmental Editor:Jennifer Pine
Developmental and Production Services:Molly Connors, Dovetail Content Solutions
As new scientific information becomes available through basic and clinical research, recommended treat-
ments and drug therapies undergo changes. The author an d publisher have done everything possible to
make this book accurate, up to date, and in accord with accepted standards at the time of publication.
The author, editors, and publisher are not responsible for errors or omissions or for consequences from
application of the book, and make no warranty, expressed or implied, in regard to the contents of the
book. Any practice described in this book should be applied by the reader in accordance with profes-
sional standards of care used in regard to the unique circumstances that may apply in each situation. The
reader is advised always to check product information (package inserts) for changes and new informa-
tion regarding dose and contraindications before administering any drug. Caution is especially urged
when using new or infrequently ordered drugs.
ISBN 13: 978-0-8036-1135-1
ISBN 10: 0-8036-1135-8
Authorization to photocopy items for internal or personal use, or the internal or personal use of specific
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Preface
Physical agents that are used to accomplish therapeutic treatment goals are capable of
causing great fear by the mere thought of their use by some clinicians. The activities
in this text, as in the first edition, are designed to provide student/learners with the
opportunity to experience each of the physical agents first hand, ask and answer per-
tinent questions regarding their application, and explore patient scenarios to help fos-
ter a greater comfort level and understanding.
Each lab activity is introduced with a purpose, objectives, and equipment needed,
as well as precautions and contraindications and the rationales for each. The intent is
to foster discussion and greater understanding of these important issues which are
part of the decision-making process in selecting a particular physical agent to accom-
plish a treatment goal. Patient scenarios are included to provide opportunities for
thoughtful dialogue between instructors and student/learners—for many individuals,
where some of the best learning opportunities occur.
The accomplishment of therapeutic treatment goals with physical agents is an art
and a science that takes time and understanding to master. These activities are in-
tended to foster further development of the application of the science, help dispel the
fears, and hopefully lead to a greater appreciation of what potentially can be accom-
plished with a sound physiological rationale.
Barbara J. Behrens, PTA, MS
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Acknowledgments
Being involved in publishing is somewhat of a thankless task for those who are in-
volved in the production side of putting together the work that the author has writ-
ten, except when someone reads the acknowledgements in a book.
Along the way, there have been many hands and minds involved in putting this pro-
ject together whom I would like to thank, including Jean-François Villain, Margaret
Biblis, and Jennifer Pine of F. A. Davis Company and Molly Connors of Dovetail
Content Solutions. Each of these individuals has had to put up with deadlines, revi-
sions, and periodic “meetings of the minds” to help bring this book together. Thank
you.
Thank you to the reviewers who lent their time and expertise to help me put together
a more cohesive version of what I had envisioned.
Thank you to my parents who have continued to encourage my seemingly endless
desire to “do more” and who have understood when I have been swamped because of
it.
Thanks to the student/learners in the PTA program at MCCC who have patiently
worked through the revision process and tolerated it well.
Thanks to Mel for always being by my side, even when I fall asleep while working
late on projects like this one.
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Reviewers
Susan Callanan, DPT Sidney Morgan
Assistant Instructor Physical Therapist Assistant
Physical Therapy Department Allied Health and Physical Therapy As-
North Iowa Area Community College sistant Department
Mason City, Iowa Northeastern Oklahoma A&M College
Miami, Oklahoma
Elizabeth A. Chape, PT, MS
Program Coordinator Maria M. Pappas, PT
Physical Therapy Assistant Program Associate Professor
Science and Allied Health Department Physical Therapy Assistant Department
Sacramento City College MassBay Community College
Sacramento, California Framingham, Massachusetts
Martha R. Hinman, PT, EdD James K. Tenpenny, AAS
Professor Associate Professor
Physical Therapy Department Physical Therapy Assistant Program
Hardin-Simmons University Kaskaskia College
Abilene, Texas Centralia, Illinois
Marlene Medin, PT, MEd Frank B. Underwood, PT, PhD, ECS
Program Director Professor
Physical Therapy Assistant Program Physical Therapy Department
Linn State Technical College University of Evansville
Linn, Missouri Evansville, Indiana
Therese Millis, PT Peter Zawicki, PT, MS
Professor Program Chair
Physical Therapy Department Physical Therapy Assistant Program
San Juan College Department of Health Sciences
Farmington, New Mexico Gateway Community College
Phoenix, Arizona
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Contents
SECTION 1: THE CONCEPT OF ADJUNCTIVE THERAPIES
1. Tissue Response to Injury 1
2. Patient Responses to Therapeutic Interventions 7
SECTION 2: THERMAL AND MECHANICAL AGENTS
3. Therapeutic Heat and Cold 19
4. Therapeutic Ultrasound 49
5. Aquatics and Hydrotherapy 67
6. Soft Tissue Treatment Techniques: Traction 83
7. Soft Tissue Management Techniques: Edema Management 103
SECTION 3: ELECTRICAL STIMULATION
8. Foundations of Electrical Stimulation 115
9. Electrodes: Materials and Care 127
10. Neuromuscular Electrical Stimulation 137
11. Electrical Stimulation for Tissue Repair 153
12. Pain Management With Electrical Stimulation 159
13. Physical Agents for Transdermal Drug Delivery: Iontophoresis and
Phonophoresis 179
SECTION 4: COMPREHENSIVE APPROACH TO TREATMENT
14. Integration of Physical Agents: Clinical Decision Making 191
APPENDIX: APPLICATION TECHNIQUES AND SEQUENCES 205
Neuromuscular Electrical Stimulation 206
Traction 208
Intermittent Compression Devices 210
Iontophoresis 212
Hydrotherapy 214
Aquatic Therapy 215
Electrical Stimulation for Pain Relief (TENS) 216
Transcutaneous Electrical Nerve Stimulation (TENS Home Unit) 218
Therapeutic Ultrasound 221
Hot Packs 223
Cryotherapy 224
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