Physicalagent modalities (PAMs) have been used by occupational therapists formany years. They are often used as adjuncts to prepare clients forfurther rehabilitation (Hunter, 2010). In most cases, the PAMsinterventions are used to manage or relieve pain in the joints or thesoft tissues. In this paper, techniques applied in differentconditions, a summary of California laws on the PAMs licensure, anddifferent types of PAMs will be discussed.
Table1: Techniques used for different conditions
Flexor tendon injuries
Six strand Savage repair
Light compression wrap
FloridaLicensure laws on the use of PAMs
TitleXXXII and chapter 468.203 of Florida statutes is among the main lawsthat regulate the use of PAMs. The chapter defines different servicesthat the occupational therapists working in Florida would be expectedto offer. The chapter also outlines interventions that theoccupational therapists are allowed to use in order to deliver theservices. From Chapter 468, occupational therapists are allowed touse physical agent modalities in preparation for a purposefulactivity (Crean, Roe & Grimes, 2015). Licensing is done by theFlorida Board of Occupational Therapy. The board is expected toassess the suitability of different modalities and the qualificationof occupational therapists to apply the modalities using theprovisions of Chapter 468 of Title XXXII (The Florida Legislature,2016). The board may also use Rule 64B11-4.001 to assess thequalification of the occupational therapists to apply varioustherapeutic techniques (such as ultrasound stimulation and electricalstimulation) and modalities (Board of Occupational Therapy, 2016).Therefore, the licensure laws focus on the qualifications ofoccupational therapists and the suitability of different PAMs for usein the field of occupational therapy.
Table2: Description of PAMs and corresponding intervention,applications as well as their contraindications
Paraffin is used to bath painful joints. The objective of using paraffin is to minimize stiffness and pain around the joints.
Paraffin relaxes stiff muscles and soothes chronic joint pain, which makes it an effective intervention for treatment of joint problems.
Paraffin should not be used during pregnancy, skin graft, cancer, and deep vein thronbophlebitis.
Hot packs refer to varying forms of moist heat that is produced in different sizes. Temperature range between 104 and 113 degrees. Hot packs should not be allowed to come into contact with the skin.
Relieves pain in the joints and muscles.
It cannot be applied for clients with skin graft, cancer, pregnancy, breeding tendencies, advanced cardiac diseases, and rheumatoid arthritis.
Involve the application of a cold gent on a swollen region.
It relieves pain and reduces inflammation as well as edema.
It cannot be applied for patients with systemic lupus, multiple myeloma, or peripheral vascular disease.
Involves the use of whirlpools to deliver cold or hot treatment
It is an effective intervention that promotes muscular relaxation, reduce muscle spasm, and pain.
It cannot be applied for patients with fever, skin conditions, and clients who require postural support.
It involves the use of an electric current to deliver therapy to soft tissues.
It helps in controlling chronic as well as acute pain, reduce muscle spasm, and facilitate tissue healing.
It cannot be applied for clients with pregnancy, cardiac disability, severe obesity, and cancerous lesions.
It is a high-intensity heat type of modality that is offered with the help of a dry whirlpool made of finely divided solid particles that are suspended in a steam of heated air.
Allow clients to exercise with their limbs, increase the blood flow, and massage the limb.
Should not be applied to open wounds, severely injured skin sensation, systematic infections, and chronic circulation obstruction disorder.
Transcutaneous electrical nerve stimulation
An electrical stimulation type of modality that is applied using low-voltage pulses.
Module and control pain. It also inhibits muscle tone.
Should not be applied for patients with central nervous system disorders, cardiac diseases, infection, CVAs.
Mostof the interventions that correspond to different types of PAMS areused to relieve pain, relax muscles, reduce inflammation, and manageedema. However, the application of different types of PAMs inCalifornia is regulated by the law. The existing laws aim at ensuringthat various interventions are safe and occupational therapists whoapply them have the necessary training.
Boardof Occupational Therapy (2016). Prescription devices (Modalitiescertification). Boardof Occupational Therapy.Retrieved May 29, 2016, fromhttp://floridasoccupationaltherapy.gov/prescription-devices-modalities-certification-faqs/
Crean,J., Roe, M. & Grimes, A. (2015). Florida occupational therapylaws and rules. WildMedical Education, Inc.retrieved May 29, 2016, fromhttp://www.therapyceu.com/courses/500/index_ot.html
Hunter,N. (2010). Therapeuticmodalities.Amsterdam: Elsevier. Retrieved May 29, 2016, fromhttp://www.physio-pedia.com/Therapeutic_Modalities
TheFlorida Legislature (2016). The 2015 Florida statutes. TheFlorida Legislature.Retrieved May 29, 2016, fromhttp://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0400-0499/0468/Sections/0468.209.html