PTA.-208 Physical Agents

Credits 2 / 1 Contact Hours
Pre-requisite: Placement into College Level Reading, completion of ELAP-120 with a 2.0 or higher, or successful completion of ACRD-090, ACRD-091 or ACRD-092; PTA.-202 . Note: Division signature required. Pre- or Co-Requisite: PTA.-204  and PTA.-208L  
Physical and physiological principles underlying the application of pelvic traction, intermittent pneumatic compression, therapeutic electricity and biofeedback.  Problem solving and application.

 

Course Outcomes
(ELECTROTHERAPEUTIC AGENTS) 1. Explain effective and appropriate electrical parameters to achieve specific goals a. Analyze the critical requirement for each parameter in the delivery of electrical stimulation (parameters include: polarity, intensity, pulse width, speed of rise, frequency, modulation, interpulse interval, intrapulse interval) b. State the basic principles of physics related to electrical safety c. Differentiate the critical requirements for electrical stimulation to achieve electrical stimulation treatment goals (peripheral nerve injuries, muscle re-education/facilitation, muscle spasm reduction, muscle spasticity reduction, wound healing, edema control, muscle strengthening, reduction of inflammation) d. Describe the indications for electrical stimulation e. Read and understands the health care literature. 2. Explain safety issues with the use of electrical stimulation a. List the contraindications and precautions for electrical stimulation b. Describe the effects of direct current on the skin c. Describe precautions in the use of specific electro-therapeutic equipment d. State the sensations that are appropriate and those that are inappropriate with the use of electrical stimulation 3. Create a presentation related to electrical stimulation a. Review the literature available for a professional research article on the use of electrical stimulation b. Compose a presentation using the format distributed in class as a checklist and on the scoring sheet c. Design a graph, chart, or other type of audiovisual to include in paper and as audio-visual to aid in clarity of presentation. d. correct grammar and spelling with the aid of a professional (available through the Writing Center in the Curtis-Mott Bldg). e. Deliver to the class on the day of the presentation, a completed and corrected copy for each member including faculty 4. Recommend appropriate electrical stimulation treatment procedures a. Detail the appropriate use of coupling media, sponges, straps/tape/vacuum attachment, leads, tips, various types of electrodes (disposable, metal, carbon-impregnated, rubber etc.). b. Contrast bi-polar, monopolar and quadripolar set-up of electrodes c. Describe the configuration of electrodes used in biofeedback d. State the criteria appropriate to determine the location of electrodes for each specific treatment goal e. State the criteria appropriate to determine the location of electrodes for each muscle f. Describe criteria used to select continuous, interrupted, surged, ramped, reciprocal modes to delivery of electrical stimulation 5. Identify appropriate electrical stimulation equipment to achieve specific goals a. Classify electric stimulation equipment b. Assess each piece of electric stimulation equipment for parameters, modes available c. Predict which pieces of electric stimulation equipment are able to achieve specific therapeutic goals 6. Explain the physiology of muscle and nerve function and the impact on parameter/equipment selection. a. Explain the onset of an action potential in nerve b. Explain the onset of an action potential in skeletal muscle c. Clarify the propagation of the impulse in a nerve and in a muscle d. Classify the order in which different muscle and nerve types are recruited normally e. Classify the order in which different muscle and nerve types are recruited electrically f. Predict the effect of current density on the muscle or nerve tissue. g. Describe the effect of changing each parameter on the ability to stimulate muscle h. Describe the effect of changing each parameter on the ability to stimulate a peripheral nerve i. Describe the changes that occur in a nerve following injury j. Describe the two major theories of pain control 7. Explain the principles of physics related to electric current production, transmission, control and electric safety a. Define a list of terms related to electrical stimulation to include: voltage, ampere, alternating current, direct current, resistance, modulation, electromotive force, current flow, peak amplitude, pulse width, frequency or rate. b. Explain how the following will effect the ability of a current to stimulate a muscle or nerve: waveform, speed of rise, ramp time, duty cycle, frequency, monopolar or bipolar set-up, intensity, pulse duration, interpulse interval, intrapulse interval, polarity of current. c. Differentiate between a monopolar set-up and bipolar set-up and the benefits/detriment and requirements of each. d. Summarize the effect of constant current versus constant voltage equipment and appropriate safety requirements for either type of equipment. 8. Locate and stimulate the motor points for all the muscles listed in chart in textbook 9. Perform correct monopolar and bi-polar electrode placement 10. Modify/identify the following controls on the available electrical stimulation equipment: waveform, modulation, duty cycle, frequency, pulse duration, intensity control and range of intensity available 11. Apply electro-therapeutic treatment procedures accurately, safely/effectively with the following goals: a. muscle re-education/facilitation b. enhance muscle integrity/strengthening c. muscle fatigue d. reduction of spasticity e. wound healing f. edema control g. increase ROM h. apply iontophoresis accurately, safely and effectively 12. Perform EMG biofeedback accurately, effectively 13. Perform electro-analgesia interventions safely and effectively: a. position and prepare patient for application of T.E.N.S. and/or other electro-analgesic treatment (includes interferential, HVPGS and PLS) b. use safety measures during treatment c. perform electro-analgesic treatment safely, accurately, effectively and efficiently d. problem solve parameter adjustment and electrode placement given specific goals and problem list e. instruct “patient’ in home use of electro-analgesic equipment f. administer standardized questionnaires, graphs, behavioral scales, or visual analog scales for pain 14. Demonstrate knowledge of low level laser therapy (athermal agent), including indications, contraindications, precautions, the physical principles and characteristics. (MECHANICAL AGENTS) 1. Describe the rationale and principles of traction 2. State physiological basis of traction 3. State appropriate goals/indications 4. State precautions/contraindications 5. Describe the procedure and equipment necessary 6. List factors contributing to dosage 7. Describe mechanical principles and rationale for use of intermittent pneumatic compression 8. List physiological effects of intermittent pneumatic compression 9. State indications/goals of intermittent pneumatic compression (IPC) 10. State the precautions/contraindications in the use of IPC 11. Describe the procedure and equipment necessary for IPC treatment 12. Perform effective and safe intermittent pneumatic compression treatments 13. Perform effective and safe spinal traction treatments (ATHERMAL AGENTS) 1) Describe the rationale, principles and physiological effects 2) State appropriate goals/indications 2) State precautions/contraindications 4) Describe the procedure 5) List factors contributing to dosage 6) Describe the procedure for establishing a MED with UV 7) Perform an ultraviolet treatment and MED test to include: a. preparation of equipment/patient b. explanation of procedure/purpose c. safety precautions followed: bell, contraindications, goggles, skin inspection d. position patient/equipment e. monitor patient response f. respond to patient check g. effectiveness of treatment 8) Use of effective/appropriate teaching techniques during lab simulations of patient- care situations