PHYSICAL AGENTS

Therapeutic Modalities
 Physiotherapy
 What is Physiotherapy?
 Physiotherapy is the utilization of physical
agents (Electrotherapy Modalities)and
techniques(Therapeutic Exercises) in the
diagnosis and treatment of disabilities and
impairments
 Classification of Therapeutic
Modalities
 Thermal

 Electromagnetic
 Includes electrical stimulating currents, diathermy.

 Mechanical
 Traction, intermittent compression, massage
Thermotherapy
 Thermotherapy
 Physiological Effects of Heat
 Dependent on type of heat energy applied,
intensity of energy, duration of exposure and
tissue response
 Desired effects
 decreasing joint stiffness; reducing pain; relieving
muscle spasm; reduction of edema and swelling;
increasing blood flow
Classification of Therapeutic Modalities
Superficial
SuperficialHeating
HeatingModalities
Modalities Hydrocollator
Hydrocollator
Depths Hot
Hotpacks,
Depthstoto0.5-2
0.5-2cm
cm packs,
Whirlpool,
Whirlpool,
th
th Paraffin
Paraffinwax,
wax,
Infrared
Infraredlamp
lamp
ep Fluidotherapy
Fluidotherapy
ep
DD
Shortwave diathermy,
Microwave diathermy,
Deep
DeepHeating
HeatingModalities
Modalities Ultrasound,
Depths
Depthsto
to3-5
3-5cm
cm Laser

Superficial and Deep heating agents increase the skin temperature

within the therapeutic range of 104°F to 113°F in order to provide
.physiological effects for therapeutic benefits
Hydrocollator (hot) Packs
 Indications
 Used for general
muscle relaxation and
reduction of pain-
spasm-ischemia-
hypoxia-pain cycle
 Limitation - unable to
heat deeper tissues
effectively
Whirlpool Bath

 Indications
 Combination of
massage and water
immersion
 Swelling, muscle spasm
and pain
Paraffin Bath

 Indications
 Useful in treating
chronic injuries .tendon
injury .
 Effective for angular
areas of body such as
hands, wrists, elbows,
ankles and feet
 Cryotherapy
 Cryotherapy or ice therapy is the application of
cold to the body tissues after injury. This
practice is as old as medicine itself.
 Nowadays, local cold application may be
applied by the use of various forms of ice or
frozen gel packs ,skin temperature is reduced
to 10 C°.
 Cryotherapy
 Used in first aid treatment of trauma to the
musculoskeletal system
 When applied intermittently with compression,
rest and elevation it reduces many adverse
conditions related to inflammation and the
reactive phase of an acute injury
 Physiological Effects of Cold Circulatory
Response
 The initial skin reaction to cooling is an attempt to
preserve heat. It is accomplished by an initial
vasoconstriction. This haemostatic response has
the effect of cooling of the body part.
 After a short period of time, the duration depends
on the area involved, a vasodilatation follows
with alternating periods of constriction and
dilatation. This reaction of “hunting” for a mean
point of circulation is called “Lewis’s Hunting
Reaction”.
 Most common types of cold therapy are ice packs and
ice massage
Electrotherapy
 Definition of Electrotherapy
 Electro – Electric Current / Electrical Energy.
 Therapy – Treatment of disease, Non-surgical
treatment approach.
 It means various forms of THERAPEUTIC
applications using ELECTRICAL ENERGY as
primary source.
 Uses of Electrotherapy in general
 Pain management
 Treatment of neuromuscular dysfunction
 Improves range of joint mobility
 Tissue repair
 Acute and chronic edema
 Peripheral blood flow
 Urine incontinence
 Electrotherapy is used for relaxation of muscle
spasms, prevention of disuse atrophy, increase
of local blood circulation, muscle rehabilitation
and re-education electrical muscle stimulation,
maintaining and increasing range of motion,
management of chronic pain, post-traumatic
acute pain, post-surgical acute pain
SWD (SHORTWAVE DIATHERMY)
SWD (SHORTWAVE DIATHERMY)
 SWD – INTRODUCTION
 Application of High-Frequency Electromagnetic
Energy
 A deep-heating modality
 Does Not stimulate MOTOR & SENSORY NERVES.
 No Danger of CHEMICAL BURNS.
 Frequency
 27.12 MHz at wavelength of 11 M
 Short-wave diathermy is used in medical therapy to
produce local heating in tissue through the conversion
of electromagnetic energy into thermal energy.
 Physiologic Responses to SWD
 Tissue Temperature Increase
 Increased Blood Flow (Vasodilatation)
 Increased Venous and Lymphatic Flow
 Increased Metabolism
 Changes In Physical Properties of Tissues
 Muscle Relaxation
 Analgesia
 Indications of SWD
 Disorders of Musculoskeletal System;

 ( Sprain, Strain, Muscle & Tendon tear,

Capsule lesion, Joint stiffness, Hematomas)
 Sub acute & Chronic Inflammatory Conditions;

(Bursitis, Synovitis, Sinusitis,, Fibrositis,

Myositis)
 MICROWAVE
DIATHERMY – (MWD)
 MICROWAVE DIATHERMY –
(MWD)
 The microwave diathermy gives superficial
heating.
 Where energy is first absorbed at the skin and
a part of it penetrate and absorbed in deep
tissues.
 MWD Has Higher Frequency and Shorter
Wavelength Than SWD
 Generates Strong Electrical Field and Relatively
Little Magnetic Field
 The general frequency of microwave is
between 300 MHz to 300 GHz with wave
length of 10mm to 1 meter.
 The therapeutic microwave generators used
frequency of 2450MHz with wave length of
122.5mm.
 THERAPEUTIC EFFECTS OF MWD
 RELIEF OF PAIN.
 REDUCTION OF MUSCLE SPASM BY
STIMULATION OF SECONDARY NERVE
ENDINGS.
 REDUCTION OF INFLAMMATION BY
INCREASE IN BLOOD SUPPLY.
 promote healing of open skin by increase in circulation
 Control the chronic infection by increasing the
circulation.
 Fibrosis: heat increase the extensibility of fibrous
tissues such as tendons, joint capsules and scars
 INDICATIONS OF MWD

 Musculoskeletal disorders:
Sprain- strain – muscle and
tendon tear – degenerative
joint disease- joint stiffness
in superficial joints-
capsular lesions.
 2. Superficial inflammatory
or infective conditions :
Tenosynovitis – bursitis –
Synovitis – infected surgical
incisions .
  
ULTRA SOUND THERAPY (US)
Therapeutic Ultrasound
Acousticvibrations of high frequency
energy produce both thermal and
non-thermal physiologic effects.
Frequency range of therapeutic
ultrasound is 0.75 to 3.3 MHz.
Classifiedas a deep heating modality
with the ability to heat tissues to a
greater degree in less time as
compared to other superficial heating
modalities
  
ULTRA SOUND THERAPY (UST)
 PHYSIOLOGICAL EFFECTS
 It is broadly divided into 2 types
 1. Thermal Effects
 2. Non – Thermal Effects / Mechanical Effects
 Cavitations
 Acoustic Streaming / Micro streaming (Micro massage)
 Thermal Effects
  blood flow
  extensibility of structures (collagen);  joint stiffness
  collagen deposition
  macrophage activity
 Non-thermal / Mechanical Effects
  cell membrane permeability
  vascular permeability
  blood flow
  fibroblastic activity
 Altered rates of diffusion across cell membrane
 Secretion of chemotactics
 Synthesis of protein
  edema
 Diffusion of ions
 Tissue regeneration
THANKS