OCCUPATIONAL THERAPY

PHYSICAL
AGENT

SMAP
MODALITIES
REGALADO, TRISHA C.
BSOT 4A
WHAT IS
These are procedures that
PAMS are used as an
uses forms of energy
which are systematically
adjunctive method

PAMS? applied to modify client

factors that limits
preparatory engagement in
occupation.
occupational performance

1. Modulate pain
2. Modify Tissue Healing
3. Increase Tissue Extensibility WHAT ARE
IT'S USES?
4. Modify skin and scar tissue
5. Decrease edema and inflammation
6. Improve Occupational performance

Cryotherapy Transcutaneous Electrical

PAMS Thermotherapy
Therapuetic Ultrasound
Nerve Stimulation (TENS)
Ultraviolet Radiation

MENTIONED:
Neuromuscular Low Level Laser and
Electrical Stimulation Light Therapy
(NMES) Hydrotherapy
 Cryos means “cold”

CRYOTHERAPY
CRYO
application of any cold substance to the body

resulting in a withdrawal of heat from the body,

INDICATIONS
Ms spasm
During acute inflammation
effectively lowering the temperature.
Acute pain
Acute ms strain
4 DISTINCT STAGES OF SENSATION: Chronic pain
Acute ligament strain Acute swelling
1. INTENSE COLD SENSATION
2. BURNING SENSATION
Acute contusion Myofascial trigger points
3. DEEP ACHING FEELING Bursitis Ms guarding
4. ANALGESIA Tenosynovitis Ms spasm
Tendonitis Post exercise to maintain soft
Arthritic flare-up tissue elongation
Spasticity Delayed onset ms sorenes

CONTRAINDICATIONS
Cold Hypersensitivity or cold allergy (Cold
Urticaria)
Cryoglobulinemia
Raynaud’s Phenomenon
Never apply to someone with compromised
circulation, peripheral vascular disease,
Application must only be applied less than 15
hypertension or past history of frostbite
minutes to avoid vasodilation.
PARAMETERS
COLDPACKS
Wrap the cold pack in a towel
Time for 15-20 minutes
monitoring the patient's skin.
Ask patient (subjective feeling)
at the end of 2 minutes and
after 5 minutes.
Remove cold pack and dry
area.
ICEMASSAGE
Patient draped with towel to
absorb melting water
Slowly rub in small, rhythmic circles
(4 cm)
Inform the patient of the stages of
sensation
Assess the area with a light touch
to make sure anesthesia has been
achieved.
Treatment time: 3 to 10 minutes
depending on the size treated
COLD COMPRESSION
COLDIMMERSION
BATHSANDCOOL
UNITS WHIRLPOOL
Temperature of the water: For Edema reduction
between 10° and 25°C Used for digital or hand injuries
For Wound debridement
effectively
Advantage: Complete contact of the
Used following surgery to
cooling agent on the tissue as the tissue
control postoperative is completely immersed in the water.
inflammation and edema and Water temperature: 13°C to 18° C
to facilitate ROM. Treatment duration: between 15- 20
minutes
ICETOWELS VAPOCOOLANT
used to draped the cold
around the targeted area. SPRAYS
used for treatment of trigger
Towels should be quickly
points.
changed
"Spray and stretch technique"-
frequently every 5- 6
to facilitate elongation of muscle
minutes
with passive stretch.
Advantage: Able to
Effective for acute muscle
circumferentially cover an
spasms
extremity.
THERMOTHERAPY
application of heat between the

INDICATIONS
superficial agent and the tissue
Stiff joints
which soothes, relieves the pain and
Subcutaneous Trauma/wounds
increases blood flow and for muscle
adhesions Neuromas
contraction velocity. Contractures Sympathetic
Chronic arthritis nervous system
WHIRLPOOL/ BATH Subacute& chronic d/o
inflammation/cumulati Muscle spasms
HYDROTHERAPY ve trau
FLUIDOTHERAPY
HOT PACKS
CONTRAST BATH
CONTRAINDICATIONS
WARM WATER SOAK Not used on patients with circulatory impairment
PARAFFIN BATH Undetermined Edema
Not used during acute Inflammatory phase of
healing
Pregnancy- full immersion hot temperature
Infection
Rheumatoid Arthritis
Bleeding Tendencies
Advanced Cardiac Disease
PARAMETERS
WHIRLPOOL/ BATH
HYDROTHERAPY
Used as a part of wound care
It enables to have an immediate
access to the body part treated
For wound debridement- warm
temperature is sufficient
Chronic ulcers treatment: warm
water (92° to 96° F) for 10-20
minutes
WARMWATER
SOAK
Circumferential heat to
fingers allowing
mobilization of hand and
fingers while soaking
Temperature: 99°-110°F
Treatment time: 15 - 20
minutes immersion
CONTRAST BATH
Used to decrease edema in an
extremity
Improve peripheral blood flow
Used to control subacute or
chronic inflammation
Warm water temperature:
100° -110° F
Cold water temperature:
50° -70° F
Treatment time: 30 minutes
HOTPACKS
High temperature maintained for
30-45 minutes
Temperature: between
104° to 113° F
Treatment length: approximately
20 minutes
Reheat: atleast 30 minutes
Skin should appear slightly red
and warm to touch
FLUIDOTHERAPY
Primarily used on distal
extremities (hands and feet)
Has sensory effect good for
desensitization for
hypersensitive areas
First step: Preheat unit to
105° to 118° F
Open wounds should not be
placed in the unit
Treatment time: 20 minutes
PARAFFINBATH
1. Wrap/ Gloving Technique
Treatment time: 20 minutes
2. Immersion Technique
Temperature: 125°-135°F
Treatment time: 10-20 minutes
3. Brush Technique
Treatment time: 20 minutes
4. Pouring Technique
Paraffin temperature: 125°F
THERAPEUTIC ULTRASOUND
a deep heat modality that can be used as an

adjunct to an Occupational Therapy treatment in

order to facilitate the healing process, speed

recovery and to decrease pain

INDICATIONS
TWO PRIMARY PURPOSE AND Increase joint extensibility of collagen
EFFECT: fibers of tendons and joint capsules
1. HEAT DEEPER LYING TISSUES Increase joint ROM
2. HEAL TISSUE THROUGH Facilitate tissue healing
MECHANICAL, NONTHERMAL
Decrease muscle spasm, pain, chronic
EFFECTS
inflammatory process, joint stiffness, edema
Facilitate function

TRANSDUCER
CONTRAINDICATIONS
During Pregnancy
Over the reproductive organs
Over the eyes
Thrombophlebitis
Plastic Components
Area of Cardiac Pacemaker
Malignancy or tumors
Areas with Active bleeding or infections
PARAMETERS
TISSUE
LENGTHENING
Duty Cycle: 100%
Frequency: 1MHz/3MHz
Intensity: 1.0-2.5 W/cm²
Duration:5-10 minutes
INFLAMMATION
Duty Cycle: 20%
Frequency: 1/3 MHz
Intensity: 0.5-1.0 W/cm²
Duration: 3-10 minutes
PAIN
CONTROL
Duty Cycle: 100%
Frequency: 1/3 MHz
Intensity: 0.5-1.0 W/cm²
Duration: 3-10 minutes

TREATMENT TIME
BASED ON 4 PRIMARY FACTORS:    If the volume of the treated area is comparable to
1. AREA OF TISSUE TO BE approx 3x the size of the sound head, duration should be
↑
TREATED
2. INTENSITY
Higher intensities also may↓ tx time
   If vigorous heating is required, higher intensities or
3. FREQUENCY longer duration at lower intensity should be applied
4. LEVEL OF DESIRED HEATING inverse relationship between depth of penetration and
frequency