The document provides information about cold therapy and its application as a thermal agent in physiotherapy. It discusses the physiological effects of cold such as initial vasoconstriction and decreased blood flow, followed by vasodilation and increased blood flow with prolonged application. Cold therapy can help control inflammation, edema, pain, and spasticity. The document outlines different cold application techniques like cold packs, ice packs, and ice massage and provides guidance on their proper use and any contraindications to cold therapy.
Cryotherapy refers to the use of local or general body cooling for therapeutic purposes. It has various physiological effects including vasoconstriction which reduces swelling and pain, as well as decreased metabolism and nerve conduction velocity. Various methods are used like ice packs, immersion, spray or whole body cryotherapy. It has applications in rehabilitation of injuries through techniques like cryokinetics and cryostretching which combine cold application with exercises. While beneficial, risks include ice burns, nerve damage or frostbite if not properly administered.
cryotherapy means ice therapy is made up of ice and used in the treatment of an acute injury and gives instant relief to the patient with the condition going in the depth then everyone knows cryotherapy
This document discusses hot and cold applications for therapeutic purposes. Hot applications are used to relieve pain and congestion, provide warmth, and promote healing by increasing blood flow. Cold applications are used to reduce pain, control bleeding and bacteria growth, and decrease inflammation by constricting blood vessels. Both have specific indications and contraindications. Guidelines are provided for safely applying heat or cold to achieve therapeutic benefits while avoiding potential complications like burns or tissue damage.
CRYOTHERAPY BY DR. ANERI PATWARI.. .pptxAneriPatwari
This presentation will throw light on cryotherapy.
This will inform you about the types of cryotherapy.
This will increase your knowledge on principle of cryotherapy.
This will brings the information on physiological and therapeutic effect on cryotherapy.
This will lighten the the knowledge of indication and contraindications of cryotherapy.
It will inform about the cooling magnitude and the reasons of the effects.
The History of SWD
Production, Generation, Method of Application, Patient Preparation, Physiologcal and therapeutic effects, Indications, Contraindications daners of SWD, and Evidence Based Practice.
This document discusses different modalities for cold therapy and the physiological effects of cooling tissues. It describes three main methods of heat transfer from tissue: conduction, convection, and evaporation. Applying cold through these methods causes vasoconstriction, reduces inflammation and bleeding, and elevates pain thresholds. The depth and duration of tissue cooling depends on several factors, and cooling can decrease nerve conduction and muscle performance if applied for too long. In general, cold therapy has therapeutic benefits for acute injuries and rehabilitation by lowering metabolism and oxygen demand in tissues.
Cryotherapy refers to the use of local or general body cooling for therapeutic purposes. It has various physiological effects including vasoconstriction which reduces swelling and pain, as well as decreased metabolism and nerve conduction velocity. Various methods are used like ice packs, immersion, spray or whole body cryotherapy. It has applications in rehabilitation of injuries through techniques like cryokinetics and cryostretching which combine cold application with exercises. While beneficial, risks include ice burns, nerve damage or frostbite if not properly administered.
cryotherapy means ice therapy is made up of ice and used in the treatment of an acute injury and gives instant relief to the patient with the condition going in the depth then everyone knows cryotherapy
This document discusses hot and cold applications for therapeutic purposes. Hot applications are used to relieve pain and congestion, provide warmth, and promote healing by increasing blood flow. Cold applications are used to reduce pain, control bleeding and bacteria growth, and decrease inflammation by constricting blood vessels. Both have specific indications and contraindications. Guidelines are provided for safely applying heat or cold to achieve therapeutic benefits while avoiding potential complications like burns or tissue damage.
CRYOTHERAPY BY DR. ANERI PATWARI.. .pptxAneriPatwari
This presentation will throw light on cryotherapy.
This will inform you about the types of cryotherapy.
This will increase your knowledge on principle of cryotherapy.
This will brings the information on physiological and therapeutic effect on cryotherapy.
This will lighten the the knowledge of indication and contraindications of cryotherapy.
It will inform about the cooling magnitude and the reasons of the effects.
The History of SWD
Production, Generation, Method of Application, Patient Preparation, Physiologcal and therapeutic effects, Indications, Contraindications daners of SWD, and Evidence Based Practice.
This document discusses different modalities for cold therapy and the physiological effects of cooling tissues. It describes three main methods of heat transfer from tissue: conduction, convection, and evaporation. Applying cold through these methods causes vasoconstriction, reduces inflammation and bleeding, and elevates pain thresholds. The depth and duration of tissue cooling depends on several factors, and cooling can decrease nerve conduction and muscle performance if applied for too long. In general, cold therapy has therapeutic benefits for acute injuries and rehabilitation by lowering metabolism and oxygen demand in tissues.
Cryotherapy describes the use of cold application to skin and tissue. When cold is applied, heat is removed from the warmer skin through conduction and evaporation. Cold application cools skin immediately, subcutaneous tissue slightly delayed, and muscle tissue with the longest delay. Cold application causes vasoconstriction, reduces tissue metabolism and inflammation, and increases pain threshold by inhibiting nerve conduction velocity. Cryotherapy is used to reduce pain, swelling, and muscle spasm during the acute injury phase.
This document discusses the application of heat therapies in nursing. It begins by outlining some indications for heat such as relieving muscle spasm, inflammation, pain, and contractures. It then describes various methods of applying dry heat like hot water bottles, heating pads, lamps, and diathermy. Methods of moist heat like fomentations, poultices, packs, and compresses are also explained. The physiological effects of heat like vasodilation and increased blood flow are noted. Guidelines for safe application and potential complications like burns are provided. Contraindications to heat therapies are listed. In summary, the document provides an overview of different heat therapy modalities and their uses, effects, guidelines and contraindications
This document discusses temperature and humidity. It begins by defining temperature and explaining different methods of temperature measurement, including mercury thermometers, resistance thermometers, and thermistors. It then discusses measuring body temperature, factors that influence body temperature, and methods of heat transfer from the body. The document also covers thermoregulation, causes of hyperthermia, temperature changes during surgery, effects of hypothermia, and methods for preventing hypothermia, including through the use of humidity.
Diathermy uses electric currents to generate deep heat within tissues up to 2 inches below the skin's surface. It promotes blood flow and reduces pain and stiffness. Shortwave diathermy specifically uses radiofrequency currents between 10-100 MHz to heat tissues. It can treat musculoskeletal conditions like arthritis as well as injuries and infections by speeding recovery through increased circulation and metabolism. Risks include burns if not properly controlled or applied to people with medical implants. Proper electrode placement and settings are needed to target heating and avoid harming surrounding tissues.
Cryotherapy refers to the use of local or general body cooling for therapeutic purposes. It is commonly used to treat acute trauma and subacute injuries. The magnitude of cooling and heat loss from tissues depends on factors like the temperature difference between the coolant and tissue, duration of exposure, thermal conductivity of tissues, and size of area cooled. Common cryotherapy methods include ice massage, ice towels, immersion in cold water or cold whirlpools, ice packs, and vapocoolant sprays. Cryotherapy provides benefits like pain relief through vasoconstriction and reduced metabolic rate, reduced edema formation after injuries or surgery, and increased or decreased muscle tone for conditions like spasticity.
This document discusses the local application of heat and cold to the body. It states that heat and cold can be applied for local and systemic effects. Heat is used to relieve pain, muscle spasms, swelling and inflammation. It can increase blood flow and the action of immune cells. Cold is used to relieve pain by decreasing inflammation and reduce swelling by constricting blood vessels. Both heat and cold can be applied in moist or dry forms using methods like hot water bottles, compresses, baths and ice packs. Precautions are discussed for proper application times and monitoring for safety.
Therapeutic Heat: Physiological & Therapeutic EffectsSreeraj S R
Therapeutic heat can be delivered superficially using modalities like hot packs, paraffin wax baths, heating pads, fluidotherapy, hydrotherapy, and contrast baths. Deeper heating is achieved through ultrasound, shortwave diathermy, and microwave diathermy. Physiological effects of heat include vasodilation, increased tissue extensibility, reduced muscle spasm and strength initially, and increased metabolic rate and oxygen availability. Precautions must be taken with certain conditions like ischemia, impaired sensation, malignancy, or acute trauma/inflammation.
Cryotherapy uses cold to control inflammation, pain, and edema through various physiological effects. When ice is applied to skin, it conducts heat away requiring significant energy to melt. This initial vasoconstriction preserves heat for 15-20 minutes, but longer applications cause vasodilation. Cold decreases nerve conduction velocity, elevates pain thresholds, and alters muscle force generation depending on duration. Cryotherapy is used to control inflammation and edema after injuries by reducing substances like histamine. Techniques include ice packs, towels, immersion, and sprays. Contraindications include cold hypersensitivity and it should not be used over wounds or impaired healing.
The document discusses cryotherapy, including:
- How it uses cold to achieve therapeutic goals by conduction, evaporation, or convection.
- Its effects on body temperature, blood flow, nerves, muscles, and metabolism.
- Potential responses to cold like vasoconstriction, vasodilation, and increased pain threshold.
- Contraindications like cold hypersensitivity, peripheral vascular disease, or regenerating nerves.
- Proper application techniques and modalities like ice packs, towels, sprays, and immersion.
Cryotherapy involves the application of cold to induce therapeutic effects by decreasing tissue temperature. It works through mechanisms like conduction, convection, and evaporation to remove heat from the body. While cryotherapy can provide benefits like reduced pain and inflammation, it may exacerbate conditions involving impaired circulation or nerve function and cause issues in sensitive individuals. Precautions should be taken when applying cryotherapy to avoid potential contraindications or side effects.
This document discusses heat emergencies ranging from minor issues like heat cramps and heat rash to life-threatening heat stroke. The body cools itself through sweating and blood flow changes but may become overwhelmed in extreme heat. Heat stroke is a medical emergency defined by a core temperature over 104°F and altered mental status. Treatment involves rapid cooling through methods like evaporative cooling, immersion, or ice packs while providing IV fluids and monitoring for complications like hypotension, hypokalemia, or renal failure. High risk groups include the elderly, young, chronically ill, and those engaged in strenuous activity in hot conditions.
The document discusses the therapeutic uses and application procedures of local heat therapy, including various heating modalities like hot water bottles, heating pads, infrared lamps, and fomentations. It describes the physiological effects of heat in increasing circulation and metabolism, as well as indications and contraindications for different heat therapies. Precautions are outlined to prevent complications like burns during local heat applications.
Here is the complete information about short wave diathermy. our main focus is on short wave diathermy and its medical effects in physiotherapy. our main goal is to provide you short but useful information hope this helps you a lot in your studies.
This document discusses physiology of thermoregulation. It describes the role of the hypothalamus in integrating thermoregulatory reflexes and controlling effectors like sweat glands and muscles. It discusses various mechanisms the body uses to regulate temperature, including losing heat through evaporation from sweat and the respiratory system, as well as gaining and losing heat through radiation, conduction and blood flow to the skin. It also describes behavioral mechanisms like changing clothing and environment to regulate temperature.
The document discusses temperature regulation and monitoring during general anesthesia. It begins by introducing homeostasis of core body temperature and the role of the hypothalamus. It then discusses heat production, transfer, and loss in the body. The effects of anesthesia on thermoregulation are described, including impaired responses and increased risk of hypothermia. Consequences of hypothermia like increased bleeding and infection risk are covered. The document concludes by reviewing methods of temperature measurement and preferred monitoring sites.
PHYSIOTHERAPY IN VETERINARY SURGERY AND RADIOLOGYDrKanteshkumarMJ
• The growing interest in physiotherapy and rehabilitation within small animal practice presents a few challenges for the veterinary surgeon.
• There is an expectation among the public, and within veterinary law, that veterinary practitioners should be the experts on physiotherapy and rehabilitation for animals, but current training does not prepare them for this role.
• While the non-specialist vet and nurse can easily and effectively provide simple physiotherapy modalities with just basic training, qualified veterinary physiotherapists can offer a new dimension to the small animal practice and bring additional expertise and skills to the veterinary team.
• The integration of physiotherapy in practice can help to improve outcomes and promote a positive, caring image to clients.
• Hopefully, when the established post-graduate programs of study begin to produce quality research the scientific evidence base for animal physiotherapy will broaden and strengthen, ultimately enhancing the quality of overall veterinary care.
• Physiotherapy has immense potential as an alternative treatment. It is cost effective and nowadays, this important branch is also rapidly becoming recognized tool in the prevention, cure and rehabilitation of many equine, canine and feline injuries.
This document discusses the use of cold applications in healthcare. It defines dry and moist cold therapies and their indications, which include reducing muscle spasm, inflammation, pain, traumatic injury, and more. The document outlines appropriate temperature ranges for different heat and cold applications and reviews the physiological effects of cold on the body, including vasoconstriction, decreased metabolism and inflammation. Contraindications and potential complications of cold therapy are also summarized.
This document discusses cryotherapy, or the therapeutic use of local cold application. It provides details on the physical principles, indications, contraindications, physiological effects, therapeutic effects, techniques of application including immersion, ice towel, ice pack, and ice cube massage methods. Cryotherapy is used to reduce pain, inflammation, swelling and muscle spasm through vasoconstriction, decreased nerve conduction velocity, and reduced cell metabolism. Precautions must be taken to avoid dangers like frostbite.
Heat and cold applications can provide therapeutic benefits through physiological responses. Heat therapy increases blood flow and the delivery of nutrients while decreasing pain. Cold therapy decreases blood flow and inflammation while reducing pain. The duration, area, and patient condition impact the safe and effective use of heat and cold to facilitate healing. Proper documentation is required for legal purposes.
Modalities for therapeutic management of pain 1Balamurugan r
This document discusses various therapeutic modalities for pain management, including thermotherapy, electrotherapy, light therapy, and mechanical modalities. It provides details on thermotherapy modalities like hot packs, paraffin baths, whirlpools, and deep heat modalities like ultrasound, shortwave diathermy, and laser. The modalities are described in terms of their physiological effects like increasing blood flow and reducing pain, stiffness, and inflammation. Selection of modalities depends on factors like injury characteristics and physician prescription.
English Drug and Alcohol Commissioners June 2024.pptxMatSouthwell1
Presentation made by Mat Southwell to the Harm Reduction Working Group of the English Drug and Alcohol Commissioners. Discuss stimulants, OAMT, NSP coverage and community-led approach to DCRs. Focussing on active drug user perspectives and interests
We are one of the top Massage Spa Ajman Our highly skilled, experienced, and certified massage therapists from different corners of the world are committed to serving you with a soothing and relaxing experience. Luxuriate yourself at our spas in Sharjah and Ajman, which are indeed enriched with an ambiance of relaxation and tranquility. We could confidently claim that we are one of the most affordable Spa Ajman and Sharjah as well, where you can book the massage session of your choice for just 99 AED at any time as we are open 24 hours a day, 7 days a week.
Visit : https://massagespaajman.com/
Call : 052 987 1315
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Similar to NO 1163 AEF Topik 2 and 3 Thermal agents 2023.pptx
Cryotherapy describes the use of cold application to skin and tissue. When cold is applied, heat is removed from the warmer skin through conduction and evaporation. Cold application cools skin immediately, subcutaneous tissue slightly delayed, and muscle tissue with the longest delay. Cold application causes vasoconstriction, reduces tissue metabolism and inflammation, and increases pain threshold by inhibiting nerve conduction velocity. Cryotherapy is used to reduce pain, swelling, and muscle spasm during the acute injury phase.
This document discusses the application of heat therapies in nursing. It begins by outlining some indications for heat such as relieving muscle spasm, inflammation, pain, and contractures. It then describes various methods of applying dry heat like hot water bottles, heating pads, lamps, and diathermy. Methods of moist heat like fomentations, poultices, packs, and compresses are also explained. The physiological effects of heat like vasodilation and increased blood flow are noted. Guidelines for safe application and potential complications like burns are provided. Contraindications to heat therapies are listed. In summary, the document provides an overview of different heat therapy modalities and their uses, effects, guidelines and contraindications
This document discusses temperature and humidity. It begins by defining temperature and explaining different methods of temperature measurement, including mercury thermometers, resistance thermometers, and thermistors. It then discusses measuring body temperature, factors that influence body temperature, and methods of heat transfer from the body. The document also covers thermoregulation, causes of hyperthermia, temperature changes during surgery, effects of hypothermia, and methods for preventing hypothermia, including through the use of humidity.
Diathermy uses electric currents to generate deep heat within tissues up to 2 inches below the skin's surface. It promotes blood flow and reduces pain and stiffness. Shortwave diathermy specifically uses radiofrequency currents between 10-100 MHz to heat tissues. It can treat musculoskeletal conditions like arthritis as well as injuries and infections by speeding recovery through increased circulation and metabolism. Risks include burns if not properly controlled or applied to people with medical implants. Proper electrode placement and settings are needed to target heating and avoid harming surrounding tissues.
Cryotherapy refers to the use of local or general body cooling for therapeutic purposes. It is commonly used to treat acute trauma and subacute injuries. The magnitude of cooling and heat loss from tissues depends on factors like the temperature difference between the coolant and tissue, duration of exposure, thermal conductivity of tissues, and size of area cooled. Common cryotherapy methods include ice massage, ice towels, immersion in cold water or cold whirlpools, ice packs, and vapocoolant sprays. Cryotherapy provides benefits like pain relief through vasoconstriction and reduced metabolic rate, reduced edema formation after injuries or surgery, and increased or decreased muscle tone for conditions like spasticity.
This document discusses the local application of heat and cold to the body. It states that heat and cold can be applied for local and systemic effects. Heat is used to relieve pain, muscle spasms, swelling and inflammation. It can increase blood flow and the action of immune cells. Cold is used to relieve pain by decreasing inflammation and reduce swelling by constricting blood vessels. Both heat and cold can be applied in moist or dry forms using methods like hot water bottles, compresses, baths and ice packs. Precautions are discussed for proper application times and monitoring for safety.
Therapeutic Heat: Physiological & Therapeutic EffectsSreeraj S R
Therapeutic heat can be delivered superficially using modalities like hot packs, paraffin wax baths, heating pads, fluidotherapy, hydrotherapy, and contrast baths. Deeper heating is achieved through ultrasound, shortwave diathermy, and microwave diathermy. Physiological effects of heat include vasodilation, increased tissue extensibility, reduced muscle spasm and strength initially, and increased metabolic rate and oxygen availability. Precautions must be taken with certain conditions like ischemia, impaired sensation, malignancy, or acute trauma/inflammation.
Cryotherapy uses cold to control inflammation, pain, and edema through various physiological effects. When ice is applied to skin, it conducts heat away requiring significant energy to melt. This initial vasoconstriction preserves heat for 15-20 minutes, but longer applications cause vasodilation. Cold decreases nerve conduction velocity, elevates pain thresholds, and alters muscle force generation depending on duration. Cryotherapy is used to control inflammation and edema after injuries by reducing substances like histamine. Techniques include ice packs, towels, immersion, and sprays. Contraindications include cold hypersensitivity and it should not be used over wounds or impaired healing.
The document discusses cryotherapy, including:
- How it uses cold to achieve therapeutic goals by conduction, evaporation, or convection.
- Its effects on body temperature, blood flow, nerves, muscles, and metabolism.
- Potential responses to cold like vasoconstriction, vasodilation, and increased pain threshold.
- Contraindications like cold hypersensitivity, peripheral vascular disease, or regenerating nerves.
- Proper application techniques and modalities like ice packs, towels, sprays, and immersion.
Cryotherapy involves the application of cold to induce therapeutic effects by decreasing tissue temperature. It works through mechanisms like conduction, convection, and evaporation to remove heat from the body. While cryotherapy can provide benefits like reduced pain and inflammation, it may exacerbate conditions involving impaired circulation or nerve function and cause issues in sensitive individuals. Precautions should be taken when applying cryotherapy to avoid potential contraindications or side effects.
This document discusses heat emergencies ranging from minor issues like heat cramps and heat rash to life-threatening heat stroke. The body cools itself through sweating and blood flow changes but may become overwhelmed in extreme heat. Heat stroke is a medical emergency defined by a core temperature over 104°F and altered mental status. Treatment involves rapid cooling through methods like evaporative cooling, immersion, or ice packs while providing IV fluids and monitoring for complications like hypotension, hypokalemia, or renal failure. High risk groups include the elderly, young, chronically ill, and those engaged in strenuous activity in hot conditions.
The document discusses the therapeutic uses and application procedures of local heat therapy, including various heating modalities like hot water bottles, heating pads, infrared lamps, and fomentations. It describes the physiological effects of heat in increasing circulation and metabolism, as well as indications and contraindications for different heat therapies. Precautions are outlined to prevent complications like burns during local heat applications.
Here is the complete information about short wave diathermy. our main focus is on short wave diathermy and its medical effects in physiotherapy. our main goal is to provide you short but useful information hope this helps you a lot in your studies.
This document discusses physiology of thermoregulation. It describes the role of the hypothalamus in integrating thermoregulatory reflexes and controlling effectors like sweat glands and muscles. It discusses various mechanisms the body uses to regulate temperature, including losing heat through evaporation from sweat and the respiratory system, as well as gaining and losing heat through radiation, conduction and blood flow to the skin. It also describes behavioral mechanisms like changing clothing and environment to regulate temperature.
The document discusses temperature regulation and monitoring during general anesthesia. It begins by introducing homeostasis of core body temperature and the role of the hypothalamus. It then discusses heat production, transfer, and loss in the body. The effects of anesthesia on thermoregulation are described, including impaired responses and increased risk of hypothermia. Consequences of hypothermia like increased bleeding and infection risk are covered. The document concludes by reviewing methods of temperature measurement and preferred monitoring sites.
PHYSIOTHERAPY IN VETERINARY SURGERY AND RADIOLOGYDrKanteshkumarMJ
• The growing interest in physiotherapy and rehabilitation within small animal practice presents a few challenges for the veterinary surgeon.
• There is an expectation among the public, and within veterinary law, that veterinary practitioners should be the experts on physiotherapy and rehabilitation for animals, but current training does not prepare them for this role.
• While the non-specialist vet and nurse can easily and effectively provide simple physiotherapy modalities with just basic training, qualified veterinary physiotherapists can offer a new dimension to the small animal practice and bring additional expertise and skills to the veterinary team.
• The integration of physiotherapy in practice can help to improve outcomes and promote a positive, caring image to clients.
• Hopefully, when the established post-graduate programs of study begin to produce quality research the scientific evidence base for animal physiotherapy will broaden and strengthen, ultimately enhancing the quality of overall veterinary care.
• Physiotherapy has immense potential as an alternative treatment. It is cost effective and nowadays, this important branch is also rapidly becoming recognized tool in the prevention, cure and rehabilitation of many equine, canine and feline injuries.
This document discusses the use of cold applications in healthcare. It defines dry and moist cold therapies and their indications, which include reducing muscle spasm, inflammation, pain, traumatic injury, and more. The document outlines appropriate temperature ranges for different heat and cold applications and reviews the physiological effects of cold on the body, including vasoconstriction, decreased metabolism and inflammation. Contraindications and potential complications of cold therapy are also summarized.
This document discusses cryotherapy, or the therapeutic use of local cold application. It provides details on the physical principles, indications, contraindications, physiological effects, therapeutic effects, techniques of application including immersion, ice towel, ice pack, and ice cube massage methods. Cryotherapy is used to reduce pain, inflammation, swelling and muscle spasm through vasoconstriction, decreased nerve conduction velocity, and reduced cell metabolism. Precautions must be taken to avoid dangers like frostbite.
Heat and cold applications can provide therapeutic benefits through physiological responses. Heat therapy increases blood flow and the delivery of nutrients while decreasing pain. Cold therapy decreases blood flow and inflammation while reducing pain. The duration, area, and patient condition impact the safe and effective use of heat and cold to facilitate healing. Proper documentation is required for legal purposes.
Modalities for therapeutic management of pain 1Balamurugan r
This document discusses various therapeutic modalities for pain management, including thermotherapy, electrotherapy, light therapy, and mechanical modalities. It provides details on thermotherapy modalities like hot packs, paraffin baths, whirlpools, and deep heat modalities like ultrasound, shortwave diathermy, and laser. The modalities are described in terms of their physiological effects like increasing blood flow and reducing pain, stiffness, and inflammation. Selection of modalities depends on factors like injury characteristics and physician prescription.
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This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
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Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
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Help children identify and understand their own emotions and the emotions of others.
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Support Learning and Development:
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Teach Social Skills:
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This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
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NO 1163 AEF Topik 2 and 3 Thermal agents 2023.pptx
1. Topik 2 and 3: Thermal agents – Cold and Heat
NP1163: ELECTROPHYSICAL AGENT
Dr. Hafifi, Physiotherapy, FSK, UKM
1
2. Learning outcomes
• At the end of the lecture, students should be able to
• Identify the physical properties and the physiological responses of thermal agents.
• Analyse the physiological responses of thermal agents to promote healing.
• Assess the indications, contraindications, and precautions to use thermal agents
• Choose and use the most appropriate thermal agent to obtain desired treatment goals.
2023 NP 1163 EPA Thermal Agents 2
3. Principles of thermal energy
• Specific heat is the amount of energy required to raise the
temperature of a given weight of a material by a given number of
degrees.
2023 NP 1163 EPA Thermal Agents 3
Heat
Weight
material
Number of
degrees
4. • Different materials used as thermal agents and different body tissues
have different specific heats
2023 NP 1163 EPA Thermal Agents 4
5. Mode of heat transfer
• Conduction
• Heat or Cold pack
• Heat is conducted from the material at the higher temperature to the material at the
lower temperature
• Heat transfer by conduction occurs only between materials of different temperatures
that are in direct contact with each other.
2023 NP 1163 EPA Thermal Agents 5
6. • Guideline for heat transfer by conduction
• The greater the temperature difference between a heating or cooling agent the faster the rate of heat
transfer. Inflamed area response well with cold packs;
• The larger the area of contact between a thermal agent and the patient, the larger energy required to
transfer. Hot pack at the back requires larger size of hot pack
• The rate of temperature rise decrease in a proposition in proportion to the tissue thickness. Shortwave
diathermy is more suitable for thick muscle area such as gluteus maximus rather than hotpack
Therefore, conductive thermal agents are suited to heat or cooling superficial tissue but not when the goal
is to change the temperature of deeper tissue
2023 NP 1163 EPA Thermal Agents 6
7. • Convection
• Heat transfer by circulation of a medium of a
different temperature such as fluidotherapy,
whirlpool and blood circulation
• The thermal agent move to heat or cooling
the area. Ice immersion in a bowl for
inflamed ankle will cold the skin more
rapidly compare to cold pack
• Conversion
• Conversion from one type of energy to
another such as ultrasound (US) diathermy
and metabolism
• Involves the conversion of a non-thermal
form of energy such as mechanical, electrical
or chemical energy into heat.
• US cause vibration in the tissue which
generates friction between the molecules to
increase the temperature and produce heat.
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8. • Radiation
• Heating by radiation involves the direct transfer
of energy from a material with a higher
temperature to one with a lower temperature
without the need for an intervening medium or
contact such as infrared rays (IRR)
• Evaporation
• The evaporation and changes of form from a
liquid to a gas or vapor resulting in decreae of
temperature.
• Vapocoolant spray is heated by the warm skin
of the body, it changes the liquid form to a
vapor at its specific evaporation temperature.
• Evaporation of sweat, which also acts to cool
the body when it is overheated to help the
body to normalize the normal range
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10. Sensory examination
• The evaluation of sensation is highly dependent on the ability and desire of the
patient to cooperate.
• Basic testing should sample the major functional subdivisions of the sensory
systems.
• The patient's eyes should be closed throughout the sensory examination.
• Exam in this order
1.Superficial (Exteroceptive) sensation
2.Proprioceptive(deep) sensation
3.Combined cortical sensations.
• If the superficial sensation is impaired then some impairment is also seen in
deep and combined sensations.
• Sensory tests are done from the distal to the proximal direction
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12. Pain Perception
• It is also known as sharp/dull discrimination.
• To test this sensation, the sharp and dull end of any objects like a safety pin, a
reshaped paperclip, or neurological pin is used.
• The sharp and dull end is randomly applied perpendicular to the skin, should not
be applied too close to each other or in a too rapid manner to avoid the
summation of impulses.
• The patient is asked verbally to indicate sharp/dull when a stimulus is felt. All
areas of the body should be tested.
• After testing the instrument should be sterilized or disposed.
•
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13. Temperature awareness
• Two test tubes with stoppers are required for this
examination; one should be filled with the cold
water (between 5°C to 10°C) and warm water(
40°C to 45°C).
• It should be taken care that the temperature
should remain within this range for accuracy.
• The test tubes are randomly placed in contact
with the skin area to be tested.
• All skin surfaces should be tested. The patient is
asked to respond hot and cold after each stimulus
application.
• https://youtu.be/7it5E9OBl2k
Touch awareness
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• A piece of cotton, tissue, used to perceive the
light touch input.
• Needle and blunt things (pinprick test) used to
perceive the sharp and blunt sensations
• Light touch or stroke is applied in the area to be
tested. The patient is asked to indicate where
he/she recognizes that a stimulus has been
applied.
https://youtu.be/XVOVpq-41BY
15. Hemodynamic Effects
• Initial decrease in blood flow
• Cold applied to skin cause immediate vasoconstriction and reduction of blood
flow
• Persist if the duration of cold application less than 20 minutes
Karunakara RC, Lephart SM, Pincivero DM: Changes in forearm blood flow during single and intermittent cold application, J
Onhop Syons Phys Thet Mar; 29(3):177 -L80, 1999
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16. INITIAL REDUCE BLOOD FLOW
• Cold cause vasoconstrictions
• Activation of the cutaneous cold receptors
stimulating the smooth muscle of the blood
vessel walls to contracts
• Cooling also decrease the production of
vasodilator mediators (histamine and
prostaglandins) decrease the vasodilation
• Decrease the tissue temperature also activate
the sympathetic system results in
vasoconstrictions
• Reduce the circulatory rate by increase the
blood viscosity
• Cold reduce temperature and less blood flow to
the injured area
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17. LATER INCREASE IN BLOOD FLOW
• Prolonged cold application cause
vasodilation known as ‘Cold Induced
Vasodilation (CIVD)’
• The temperature cycling with alternating
vasoconstriction and vasodilation called
‘hunting response’
• ‘Hunting response’ mediated by axon reflex
in response to pain of prolonged cold or very
low temperature.
• CIVD likely to occur at the distal extremities
with application MORE THAN 15 minutes of
cold below 1 Celsius
• CIVD can be seen with the redness sign due
to increase the oxyhaemoglobin
concentration of the blood
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18. Neuromuscular effects
• Decreased nerve conduction velocity (NCV)
Decrease nerve temperature results in a decrease of nerve conduction velocity
after 5 minutes of superficial cooling
However, after 20 minutes of cooling NCV take 30 minutes or longer to
recover due to too much reduction in temperature caused by longer duration of
cooling
Cold decrease the NCV for sensory and motor nerves
A- delta fibers shows greatest decrease in cindcution after cold application
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19. • Increased pain threshold
• Decrease the sensation of pain via gate control mechanism, reduction of muscle spasm, or
postinjury oedema
• Cold may provide sufficient sensory input or partially along the spinal cord or decrease pain
sensation
• Reducing oedema can alleviate the pain that results in from the compression of nerves or
other pressure-sensitive structures
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20. • Decreased spasticity
• Due to a decrease of gamma motor neuron
• After prolonged cooling for 10 – 30 minutes due to a decrease in the discharge from
the afferent spindles and Golgi’s tendon
• Decreased metabolic effects
• Cold decrease the rate of all metabolic reactions, including those involved in
inflammation and healing
• The activity of cartilage degrading enzymes, collagenase, elastase, hyaluronidase and
protease is inhibited by decreases in joint temperature
• Cryotherapy is recommended to prevent the reduction of collagen destruction in
inflammatory joint diseases such as osteoarthritis and rheumatoid arthritis
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22. Benefits and uses of cold therapy
Briefly describes the effects of cold therapy on the following conditions
• Control of inflammation
• Control of oedema
• Control of pain
• Spasticity modification
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24. 2023 NP 1163 EPA Thermal Agents 24
Cold hypersensitivity
• Causes the patients to develop skin reaction
• Skin shows more pale or redden compare to
surrounding area
Cold intolerance
• Causes severe pain, numbness and color
changes to patients
Please describes and explain why cryotherapy is
contraindicated for the following conditions?
• Paroxysmal cold cryoglobinuria
• Regeneration of peripheral nerve
• Peripheral vascular diseases
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• Uncommon aggregation of serum proteins in the
distal circulation when exposed to cold
• Causing local ischemia and then gangrene
• May associate with Systemic Lupus Erythematosus
(SLE), Rheumatoid Arthritis (RA)
Therefore, should check with physician
26. Raynaud diseases
• Digital Cyanosis due to systemic disorder
• Characterized by sudden pallor, sudden cyanosis and
follow by redness
• Maybe associated with thoracic outlet syndrome (TOS)
or Carpal Tunnel Syndrome (CTS)
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27. 2023 NP 1163 EPA Thermal Agents 27
Superficial main branch
• Applying cold directly over the superficial
main nerve at the lateral knee or the
radial nerve at the posterolateral elbow
may cause nerve conduction block
• Therefore, one should monitor for the
sign and symptoms such as numbness,
tingling or to discontinue therapy
Open wound
• Should not apply to open
wound because it can
delay the wound healing
reducing the circulation or
metabolic rate
• Inspect the skin closely for
deep wound, cuts or
abrasions
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Hypertension
• Cold can cause increases in systolic or diastolic blood pressure, patient with
hypertension should be careful
• Discontinue therapy if the blood level beyond the safe levels
Patients with poor sensations
• The patient cannot report the discomfort the face. The clinicians should
monitors effectively discontinue therapy if the blood level beyond the safe
levels
When treating very young and very old patients
• Be careful as the young and older one frequently impaired thermal regulations
30. Cold pack VS Ice pack
COLD PACK
• Filled with gel composed of silica or mixture of saline and
gelatin and covered with vinyl
• Should be cooled for 30 minutes between uses
• Should be cooled for 2 hours or longer before initial uses
• Equipment required
• Various shape of cold pack for different areas of body
• Freezer or specialized cool unit
• Towels or pillow cases for hygiene or insulation
ICE PACK
• Made up of crush ice place in plastic bag
• More aggressive cooling than cold packs because ice has
higher specific heat because ice absorbs a large amount
of energy when it melts and changes from a solid to
liquid
• More insulation should be used when applying an ice
pack due to aggressive cooling
• Equipment required
• Plastic bag
• Ice chip
• Ice chip machine or freezer
• Towels or pillow cases for hygiene or insulation
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32. Ice and cold pack therapy
ADVANTAGES
• Easy to use
• Inexpensive materials and equipment
• Short use of clinician time
• Low level of skill required for application
• Covers moderate to large areas
• Can be applied to an elevated limb
DISADVANTAGES
• Pack must be removed to visualize the
treatment area during treatment
• Patient may not tolerate of the pack
• Pack may not be able to maintain good
contact on small or contoured areas
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33. Procedure to apply cold/ice pack
1. Assess the patient if indicated or contraindicated
2. Remove all the jewellery and clothing from the area to be treated and inspect the area
3. Perform the sensation test
4. Wrap the cold pack with towel
5. Position the patient comfortably, elevating the area to be treated if edema is present
6. Place the wrapped pack on the area to be treated and secure it well with elastic bandages or towel
to ensure the good contact with the patient's skin
7. Leave the pack in place for 10-15 minutes to control pain, inflammation and edema
• 10 minutes is the most effective
• 30 minutes for spasticity control
8. Check every 10 to 15 minutes for any sign of adverse effects
9. Provide the patient with bell or other means to call for assistance
10. When the treatment is completed, remove the pack and inspect the treatment area for any signs
of adverse effects such as rash. It is normal for the skin to be red or dark pink after icing
11. Cold or ice pack application can be repeated every 1 to 2 hours to control pain inflammation.
12. Assess the outcome of treatment
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34. ICE PACK VS COLD PACK
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COLD PACK ICE PACK
Ice pack provides more intense training
Ice pack is less expensive
Cold pack is quicker
35. Ice massage
• Ice cups or frozen water popsicles
• Frozen ice cups made by freezing small paper or
Styrofoam cups of water. To use these, the therapist
holds on to the bottom of the cup and gradually peels
back the edge to expose the surface of the ice and puts
it in direct contact with the patient’s skin.
• Wate popsicles are made by placing a stick or tongue
depressor into the water cup before freezing. When
frozen, the ice can be completely removed from the
cup and the stick used as a handle for applying the ice
• Patients can easily make ice cups or popsicles for home
use
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37. Ice massage
Advantages
• Treatment area can be observed
during application
• Can be used for small and
irregular areas
• Short duration of treatment
• Inexpensive
• Can be apply to an elevated limb
Disadvantages
• Too time consuming for large
areas
• Requires active participation by
the clinician pr patient
throughout the application
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38. Procedure of ice massage application
1. Assess and check if the patient indicated or contraindicated for the treatment
2. Remove all the jewellery and clothing from the area to be treated and inspect the area
3. Perform the sensation test
4. Position the patient comfortably, elevating the area to be treated if edema is present
5. Place towels around the treatment area to absorb any dripping water and to wipe away water on
the skin during treatment
6. Rub the ice over the treatment area using small, overlapping circles. Wipe away any water as it
melts on the skin
7. Continue ice massage application for 10-15 minutes or until the patient experiences analgesia at
the site of application. The ice is either rubbed with pressure for 3 to 5 seconds or quickly stroke
over the muscle bellies to be facilitated. This technique is known as quick icing
8. When the treatment is completed, inspect the treatment area for any signs of adverse effects
such as rash. It is normal for the skin to be red or dark pink after icing
9. Assess the outcome of treatment
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39. Cold compression/Cryocuff unit
• Controlled cold compression units alternately pump cold water and
air into a sleeve that is wrapped around a patient’s limb
• Normal cryocuff don’t have the pump, but have air vent instead to
drain water into sleeve
• Equipment required:
• Controlled cold compression unit/cooler
• Sleeves for appropriate targeted treatment
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41. Cold compression/Cryocuff unit
Advantages
• Allows simultaneous of cold and
compression
• Temperature and compression
force are easily and accurately
controlled
• Can be applied to large joints
Disadvantages
• Treatment site cannot be
visualized during treatment.
• Expensive
• Usable only for extremities
• Cannot be used for trunk or
digits
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46. The procedure to apply cold
compression/cryocuff
1. Assess the indication and contraindication of the patient
2. Remove all the jewellery and clothing from the area to be treated and inspect the area
3. Perform the sensation test
4. Prepare the cold compression device
5. Position the patient comfortably, elevating the area to be treated if edema is present
6. Cover the limb with a stockinette/towel before applying the sleeve
7. Wrap the sleeve around the area to be treated
8. Elevate the area to be treated
9. Apply cooling for 15 minutes every 2 hour for acute swelling
10. Provide the patient with bell for assistance
11. When the treatment is completed, remove the sleeve and inspect the treatment area
12. Assess the outcome of treatment
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47. Classroom activities:
Please demonstrates the application of
cold therapy for people with joints swelling
(ankle, knee, elbow, wrist and shoulder)
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51. Contraindication
• Acute injury or inflammation
• Recent or potential
haemorrhage
• Thrombophlebitis
• Impaired sensation
• Infrared radiation of the eyes
• Pregnancy
• Impaired circulation
• Poor thermal regulation
• Edema
• Cardiac insufficiency
• Metal in the area
• Over an open wound
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Precaution
57. Procedure of hot packs application
1. Assess and check if the patient indicated or contraindicated for the treatment
2. Remove all the jewellery and clothing from the area to be treated and inspect the area
3. Perform the sensation test
4. Position the patient comfortably
5. Wrap the hot pack in six to eight layers of dry towels. Towel should not removed during the treatment
6. Apply the wrapped hot pack and cover it well for 20 minutes. After 5 minutes, check and inspect the area
being treated for excessive redness, blistering, or other signs of burning
7. Provide the patient with bell for assistance
8. After 20 minutes, remove the hot pack and inspect the treatment area. lt is normal for the area to appear
slightly red and to feel warm to the touch
9. Assess the outcome of treatment
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58. Hot packs
Advantage
• Easy to use. Inexpensive materials
(packs and towels)
• Short use of clinician's time
• Low level of skill needed for
application
• Can be used to cover moderate to
large areas
• Safe, as packs start cooling on
removal from the water cabinet
• Readily available for patient purchase
and home use
Disadvantage
• Hot pack must be moved to observe
the treatment
• Patient may not tolerate the weight of
the hot pack
• Pack may not be able to maintain
good contact with small or contoured
area
• Active motion not practical during
treatment
• Moderately expensive equipment
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61. Procedure application of paraffin wax
1. Assess and check if the patient indicated or contraindicated for the
treatment
2. Remove all the jewellery and clothing from the area to be treated and
inspect the area. Thoroughly was and dry the area to be treated to
minimize contamination of the paraffin
3. Perform the sensation test
4. Position the patient comfortably
5. Applied the wax via either one of these techniques 1) Dip immersion wrap
2) Dip immersion method 3) Paint method
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62. Dip immersion wrap
1. With fingers apart, dip the hand into the paraffin as far as possible and remove . Advise the patient to avoid
moving the fingers during the treatment because this will crack the paraffin coating. Also, advise the patient
to avoid touching the sides or bottom of the tank because these may be hotter than the paraffin
2. Wait briefly for the layer of paraffin to harden and become opaque
3. Redip the hand, keeping the fingers apart, repeat steps 2 through 5 six to ten times.
4. Wrap the patients 'hand in a plastic bag, wax paper or treatment table paper and then in a towel. The plastic
bag or paper prevents the towel from sticking to the paraffin, and the towel acts as insulation to slow the
cooling of the paraffin. Caution the patient not to move the hand during dipping or during the rest period
because this may crack the coating of paraffin, allowing air to penetrate and the paraffin to cool more rapidly
5. Elevate the extremity
6. Leave the paraffin in place for 10 to 15 minutes or until it cools
7. When the treatment is completed, peel the paraffin off the hand and either replace the paraffin in the
container to melt or discard it
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63. Dip immersion method
1. With fingers apart, dip the hand into the paraffin and remove.
2. Wait 5 to 15 seconds for the layer of paraffin to harden and become
opaque.
3. Redip the hand, keeping the fingers apart.
4. Allow the hand to remain in the paraffin for up to 20 minutes and then
remove it.
5. The temperature of the paraffin should be at the lower end of the range
for this method of application because the hand cools less during
treatment than with the dip-wrap method.
6. The heater should be turned off during the treatment so the sides and
bottom of the tank do not too hot.
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64. Paint method
1. Paint a Iayer of paraffin onto the treatment with a brush.
2. Wait for the layer of paraffin to become opaque.
3. Paint on another layer of paraffin no larger than first layer.
4. Repeat steps 3 through 5 six to ten times
5. Cover the area with plastic or paper and then with towel
6. As with the dip-immersion method, plastic or paper is used to prevent the towel
sticking to the paraffin and the towel acts as insulation to slow down the cooling of
the paraffin
7. Caution, the patient not to move the area during treatment as this may crack the
coating of paraffin allowing air to penetrate and the treatment area cool more rapidly.
8. Leave the paraffin in place for 20 minutes or until cools.
9. When the treatment is completed, paraffin and either replace it in the melt or discard
it.
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65. • For All Methods:
• When the treatment is complete. Peel off the paraffin and either
replace it in the container to melt or discard it
• Paraffin may be sterilized by heating it to 80 'C ',176 'F) and then
allowing it to cool overnight. Its temperature should be allowed to
return to between 45' and 50 'C (773' to 122'I) before it is used again
for treatment
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66. Paraffin wax
Advantages
• Maintains good contact with highly
contoured areas.
• Easy to use.
• Inexpensive.
• Body part can be elevated if using
the dip-wrap method
• Oil lubricates and conditions the
skin.
• Can be used by patient at home
Disadvantages
• Messy and time-consuming to
apply.
• Cannot be used over an open skin
lesion as it may contaminate the
lesion
• Risk of cross-contamination if
reused.
• Part in dependent position for
method
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67. Infrared lamp
1. Assess and check if the patient indicated or contraindicated for the treatment
2. Remove all the jewellery and clothing from the area to be treated and inspect the area
3. Perform the sensation test
4. Position the patient comfortably
5. Allow the IR lamp to warm-up for 5 to 10 minutes so it will reach a stable level of output
6. Position the patient with the surface of the area to be treated perpendicular to the infrared (IR) beam and
about 45 to 60cm away from the source. e. Remember that the intensity of the IR radiation reaching the
skin decreases, with an inverse square relationship, as the distance from the source increases, and in
proportion to the cosine of the angle of incidence of the beam. Adjust the distance from the source and
wattage of the lamp output so that the patient feels a comfortable level of warmth. Measure and record the
distance of the lamp from the target tissue
7. Apply the IR for 20 minutes. Set the time at the machine. After 5 minutes, check and inspect the area being
treated for excessive redness, blistering, or other signs of burning
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68. Continue..
8. Instruct the patient to avoid moving closer to or farther from the
lamp and to avoid touching the lamp since movement toward or away
from the lamp will alter the amount of energy reaching the patient
9. After 20 minutes, remove the IR and inspect the treatment area. lt is
normal for the area to appear slightly red and to feel warm to the touch
10. When the treatment is completed, tum off lamp and dry any
perspiration from the area
11. Assess the outcome of treatment
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69. Infrared lamp
Advantage
• Does not require contact of the
medium with patient. This reduces
the risk of infection and possible
discomfort of the weight of a hot
pack.
• Also avoids the problem of poor
contact when in highly contoured
areas.
• The area being treated can be
observed during the treatment
Disadvantage
• Infrared radiation is not easily
localized to a treatment area.
• It is difficult to ensure consistent heat
in all treatment areas because the
amount of heat transfer affected by
the distance of the skin from radiation
source and the angle of the beam the
skin, both of which vary with tissue
and may be inconsistent between
sessions
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70. Classroom activities:
Please demonstrates the application of
heat therapy for people with muscle pain
(neck, shoulder, upper back, lower back,
hamstring, calf)
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71. References
Cameron, M.H (2003). Physical Agent in Rehabilitation From Research To Practice. Saunders
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