Interview with Dr. Neil Spielholz

This curriculum guideline on Physical Agents/Electrotherapy represents curricular content recommendations based upon feedback from physical therapy educators via a survey conducted by the Section on Clinical Electrophysiology and recommendations from the Electrotherapy/physical Agents
Practice Committee of the Section. New topics will be added when evidenced-based, clinical research provides documented support from controlled or randomized trials published in peer-reviewed journals.

Individual practice setting, Practice Acts, Rules and Regulations regarding physical therapy practice may determine practice limitations and role delineation.

Terminal Behavioral Objectives

After didactic and clinical education, given the results of a client’s evaluation and history, the graduate physical therapist will:
Given the results of a patient/client’s evaluation and history, and the plan of care established by a PT, the PTA student will be expected to:

IDENTIFY, DESCRIBE AND EXPLAIN indications for interventions utilizing physical agents and electrotherapeutic modalities.

IDENTIFY contraindications & precautions to the application of therapeutic modalities.
SELECT the appropriate modality (PTA Students, within the established plan of care)
APPLY the modality in a safe & effective manner.
EXPLAIN normal and abnormal physiologic responses and psychologic reactions to treatment

MODIFY modality application as indicated by the patient/client’s response. (PT A students, through consultation with the PT)
ASSESS treatment outcome in response to the application of a physical agent or electrotherapeutic modality.
INTERPRET patient/client’s response to treatment and make clinical decisions regarding treatment plan. (PTA students, through consultation with the PT)
DOCUMENT specific treatment parameters, application techniques, and treatment outcome.

Physical Agents & Electrotherapeutic Modalities Content Outline

I. Prerequisite and/or Concurrent Information
Basic Clinical tests and measurements
Neuromuscular
Muscle Strength and Endurance
Sensory Perception Testing
cutaneous pain, temperature, touch, pressure
cognitive awareness
Reflex Testing
Basic gait analysis
Neuroanatomy and Basic Neurophysiology
Cardiovascular System
Peripheral Circulatory System
Edema
Heart Rate, Blood Pressure (Vital signs)
Musculoskeletal System
Active & Passive Motion
Basic Postural Assessment
Human Systems and Cellular Physiology
Human Anatomy: neural, muscular, skeletal
Clinical Histology and Pathology including but not limited to:
Inflammation, wounds (burns, ulcers, tissue trauma) & tissue healing
(skin, nerve, tendon, muscle, joint structures)
Pain and Pain Control
Circulatory Disorders
Fundamentals of physics, biology, chemistry
Clinical Pharmacology:
Basic concepts related to potential interactions of drugs with
clinically administered physical agents as appropriate. (e.g. sensitivity to UV, wound care,
inflammatory conditions, clotting factors)
Clinical Neurology, Myology

II. Physical Therapy Clinical Knowledge and Skills
Thermotherapy
Conductive Heating Agents:
Hot Packs
Paraffin
Hydrotherapy
Fluidotherapy
Deep Heating Agents:
Thermal Diathermy, Short-wave diathermy
Ultrasound
Cryotherapy:
Cold packs, Ice packs, Cold Compresses
Ice Massage
Contrast Immersion baths
Cold Compression Devices
“vapocoolant sprays”
Actinotherapy:
Ultraviolet
Low Power laser

Physical Therapy Clinical Knowledge and Skills continued
Mechanotherapy:
Mechanical Traction
Intermittent Pneumatic Compression Devices
Electrotherapy: contemporary electrical stimulation programs and required characteristics
of stimulators utilized for:
Pain control
Neuromuscular Electrical Stimulation for:
Muscle Strengthening
Restricted Joint Motion
Hypertonic/Hypotonic Muscle (e.g. spasticity)
Activation of Muscle for Joint Positioning,
Postural Control or Enhancement of
Functional Movement or Motor Control
Tissue Healing and Tissue Repair
Enhancement of Wound Heating & Circulation
Osteogenesis, Edema Control
Medication Delivery: Iontophoresis of Analgesics &
Anti-inflammatory Agents, etc.
Electrical Stimulation of Denervated Muscle
Other Topics for Inclusion:
Topical Hyperbaric Oxygen Therapy
Pulsed Ultrasound (Non-thermal US)
Pulsed Radio Frequency Radiation (non-thermal)
Phonophoresis
Biofeedback: electromyographic & temperature

III. Common Features of Physical Agents & Therapeutic Modalities Topics
Physics of Heat, Light, Electricity, Mechanical Principles
Fundamental Concepts &Terminology
Electrotherapy: Describe, Differentiate and Recognize
Types of Electrical Current, Common Amplitude and Time
Dependent Characteristics of Electrical Stimuli
Physiologic Effects of Heat, Electromagnetic Radiation, Electricity,
Mechanical Forces {Normal, Desired effects vs. abnormal or adverse effects)
Instrumentation:
Calibration and Maintenance
Safety Considerations
Principles of Operation
Indications for Clinical Application
Clinical Application Principles and Procedures
Clinical Problem Solving Skills (case study examples)
Supervised laboratory Experiences (Academic and Clinical)
Contraindications/ precautions and potential adverse reactions to the application of each physical
agent

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