Introduction Indication Contra indication Superficial thermal agent

1. Superficial Thermal
Agents
Dr.Quazi Huma
MPT (Neursociences)

2. Objectives
 At the end of the lecture learner must be able to understand
 What is Superficial Thermal Agents
 Different heating modalities
 Hydrocollator Packs or Moist pack- its physiological effects, Indication, Contraindiaction and
Methods of Application

3.  Heat of Modalities :
 Hot Packs
Paraffin Wax Bath
 Whirlpool Baths
Infrared Radiation

4.  Physiological Effects of Heat Modalities
:
Heating effect
in Epidermis &
Dermis
Vasodilation
O2
Nutrient
Supply
In that area
Drainage of
waste products
Pain
Relie
f
Heat

5.  Hot Packs
 Canvas pouch with Silica Crystal.
 Pack is kept in a water filled heating unit maintained between 𝟏𝟔𝟎𝟎F to
𝟏𝟕𝟎𝟎 F.
 Pack Maintain temperature for 30-40 minutes.

6.  Set Up :
Cover pack with terry cloth or towel covering.
Place pack on patient in comfortable manner.
Check patient within 5 to 6minutes for comfort.
Allow 3-4 hours minimum between treatments on the same
day.

7.  Precautions :
Infected Areas must be covered with Gauze.
Do not allow the patient to lay on the heat pack

8.  Indications :
Sub acute or chronic inflammatory conditions.
Decreased ROM
Reduction of joint contractures.
Infection
Reduction of subacute or chronic pain.

9.  Contraindications :
 Acute conditions
 Peripheral vascular disease
 Impaired circulation
 Poor thermal regulation.

10.  Dangers :
Burns
Dehydration

11. Fig.1: Hydrocollator
Fig. 2: Hydrocollator Hot Packs

12.  Paraffin Wax Baths :
 A mixture of wax and mineral oil in a ratio 7 : 1.
 Temperature of wax is between 𝟏𝟏𝟖𝟎
F to 𝟏𝟐𝟔𝟎
F.
 Used to deliver heat in uniform amounts to small irregularly shaped
areas.
 Especially when ROM exercises are not a part of the treatment.

13.  Set Up :
A. Immersion Bath Method :-
 Clean body Part
 Dip part quickly allow 10 seconds to dry (Turns milky).
 Dip the extremity 6 -12 times.
 Then cover with towel for duration of time (10 to 15 min.).
 After time scrape of and replace in bath.

14.  Set Up :
 Immerse extremity in bath and allow wax to dry.
 Repeat 7 – 12 more times.
 Following times remove wax and return to bath.
 After final withdrawal from wax, Cover extremity with Wax paper,
then wrap in towel.
 If indicated elevate body part.

15. Methods of application

17.  Precautions :
 Sensation is different from specific heat and thermal capacity.
 Avoid using with athlete who are required to catch or throw a ball
(e.g. Basket ball Players).

18.  Indications :
Sub acute and chronic inflammation.
Limitation on ROM after immobilization.

19.  Contraindications :
 Open wounds
 Skin infection
 Sensory loss
 Peripheral vascular disease.

20.  Dangers :
Burn
Aggravation of inflammation.

21. Fig. 6: Paraffin Wax Bath
Unit

22. Whirlpool Baths :
 The whirlpool is a large tub that is filled with water

23.  Whirlpool Baths :
 Tank temperature is between 𝟏𝟎𝟓𝟎F to 𝟏𝟏𝟐𝟎F for extrimities and
𝟏𝟎𝟎𝟎F𝟏𝟎𝟖𝟎F for whole body.
 Tank times usually last 5 – 10 Minutes.

24.  Precautions :
 Must be connected to ground – fault indicator.
 Instruct patient not to turn whirlpool motor on or off while in
whirlpool.
 Keep Clothing or Bandages out of whirlpool.
 Patient should be continually monitored.
 Do not run the whirlpool dry.

25.  Indications :
 Decreased ROM
 Sub acute and chronic inflammatory conditions.
 Stiffness and soreness
 Chronic oedema
 Peripheral vascular disease.

26.  Contraindications :
 Acute conditions where water turbulence
 Fever above 𝟏𝟎𝟏𝟎F
 Comprimised circulation
 Patient requiring postural support during treatment.
 Dangers :
o Shouldn’t stay in a hot whirlpool for more than 20
minutes.

27. Fig. 7: The Whirlpool
Baths

28.  Infrared Radiation :
 Infrared rays are electromagnetic waves.
 It lies between visible light & microwaves
 Wavelength : 750 nm to 40000 nm.
 Frequency : 4 × 𝟏𝟎𝟏𝟒 Hz and 7.5 × 𝟏𝟎𝟏𝟏 Hz.

29.  Types of IR Lamps :
A.
• Non Luminous Generators
B.
• Luminous Generators
 There are 2 types of Infrared sources are used in Physiotherapy
Practice :

30. A. Non – Luminous Generators :
 Also known as low temperature generators.
 Produces only infrared rays of wavelength 750 nm to 15000nm.
 Non – luminous is less penetrating than luminous.

31. B. Luminous Generators :
 Also known as high temperature generators.
 Emits visible rays, Ultraviolet rays, and infrared rays of wavelength
350 nm to 4000 nm.
 Luminous generator in form at incandescent bulb.
 Luminous produces some visible light (as opposed to non –
luminous).

32.  Depth of Penetration of Rays :
 Depth of penetration of electromagnetic radiation.
Depends upon –
i. Wavelength of radiation
ii. Nature of material
Human skin allows penetration of IR :
- Minimum depth approximately : 1200 nm
- Maximum depth of penetration : 3mm.

34.  Technique of Treatment :
1) The Choice of apparatus :
 When there is inflammation injury, The sedative effects of rays
obtained from non – luminous generator may prove more effective
for relieving pain.
 For lesion of a more chronic type, shorter rays may prove to be
effective so luminous generator is chosen.

35. 2. Preparation of Patient :
 Patient positioned in comfortable posture.
 Treatment part is uncovered & skin is checked for its sensation
against heat & Cold.
 Skin must be clean & dry
 Physiotherapist should be explained about treatment and its effect

36.  Lamp is positioned in a way that radiation is at right angle to skin.
 Lamp set at a distance of 50 – 70 cm from body surface
 Switch on lamp for 10 – 20 minutes depending on surface area
 Patient’s face must not be exposed to IR, eyes must be shielded.

37.  Therapeutic Effect of IR :
In Relieving pain
In muscle relaxation
In increasing blood supply
Joint stiffness
Skin lesions

38.  Dangers :
 Burn
 Blood Supply Decrease
 Eye damage
 Dehydration
 Electric Shock Gangrene
 Headache
 Faitness
 Skin irritation

39. Fig. 8: Infrared Lamp

40.  Reference Book :
 Clayton’s Electrotherapy 8th Edition
 Textbook of Electrotherapy 2nd Edition Dr. Jagmohan Singh