THERMOTHERAPY (Heating ) Thermal agents produces heat Superficial and deep heating modalities Physiological effects (disscusion) Superficial

heat modalities Heat: pain relief tissue extensibility Healing process Paraffin wax bath In a room temp. Solid like wax Once heated liquified Unit- paraffin wax bath unit Max: 44 deg celsius Wax mixed with mineral oil- reduce the tempt in melting paraffin wax. Minimize burn in px. Ratio: 1:7 mineral :paraffin Thermostat- maintain tempt paraffin wax applied in areas with bony prominences to promote even heating. Disadvantage: easily cool down Materials: Plastic (optional, to contain the heat being treated) Wax paper - contain the heat and prevent spillage of wax Towel- further contain the heat Mug- scoop the liquified paraffin wax Brush- apply the paraffin wax 2 techniques Brushing- apply using brush Dipping- dip the area to be heated, more heating effect

Apply in the uppermost edge Once thick, stop blowing DIP After brushing, dip in paraffin wax bath unit (only up to the part where it is coated with 3-4 layers) wrap with wax paper and towel Use velcro if px wants to move From time to time ask px how she feels Remove after 15 minutes Exercise- let them play with the wax (grasping exercises) If oily apply alcohol after Check skin condition- erythema or pain After care- Recycle wax, clean mug and brush using tongue depressor and cover lid of unit. Hot moist pack A.K.A Hydrocollator packs Cervical and lumbar hot packs Utilizes- Pebbles, sand and gel. Advantage of gel- lighter Hot pack applied anywhere except in the face (heavy and not nice to look at) Advantage of hot packs- gradual release of heat Disadvantage of hot packs- Heavy, doesn't follow the contour Materials and equipment: Hydrocollator unit or tank, heater, stove If heater turn off first Tong- hold and transfer hot pack Towel ( turkish towel) Rubber sheet- to prevent spillage, prevent burn Disadvantage- serves as an insulator Procedure:

Areas: Hands, wrist, elbow, forearm, leg, arms, knee, ankle. Procedure: Px wash the area to be applied Position the px Explain rationale Warn the px (inform px- mild comfortable warm or may cause burn) BRUSHING Scoop the liquefy wax, cover unit, place in wax paper Introduce wax to px, inform Let the px feel the heat, apply layer as an insulator (3-4 layers) , apply with blow for first layer

Place rubber sheet on the table Get the hot moist pack with the tong Drain excess water. Wrap with rubber sheet and then with towel (1-2 layers depends on px tolerance) Apply to area After 20 minutes remove Check px skin condition or perform exercises After care: dry the rubber sheet with a towel and hang it. Place hot pack in the tank after use. Technique wrapping cross technique (side of the length first then of the width)

Infrared radiation IR UVR Bulb at the center - UV ray 2 rods- emit IR Advantage- not heavy on the part of the px Disadvantage-not all parts of the body can be heated up 2 types: luminous and non-luminous Sun-UVR; heat -IR Knob- timer 0-10 mins Apply for 20 mins Wire guard- to avoid contact with the rod modality can be tilted and moved to any position Inform px - mild comfortable warm and prone to burns, not to sleep or touch the modality. Tell px not to look at the machine Adjust height and angle of lamp Luminous IR Lamp 15-20 mins (usually heating) Advantage: portable Disadvantage: unstable Cardboard- to focus IR in a certain direction, 55 cm Distance starting from edge of the lamp18-20 inches Ask the px about the heat, maintain distance Adjust distance if px does/nt feel heat Area to be treated must be perpendicular for max absorption Ask px from time to time Lamp: Cannot be apply directly over the px, for precaution if the modality falls Case: low back pain Px must be side-lying 2 pillows in head,1 between legs, 1 in front of px Drape the px Modality must be perpendicular- Modify/Change the height of table or bed Check every 5 mins - thx: place palmar hand nearest to the area being treated Inform- Px not to move, not to look at the IR lamp SOP: Px wear IR opaque googles/ googles protect from radiation Edema of the hands Elevate hand above heart level with (3-4 pillows) Position px 18-20 inches away from modality Bells palsy If no protective googles, use cotton for eyes Wet cotton first cover one side of the face with towel

WHIRLPOOL hydrotherapy Several types Extremity tank Low buoyancy- px can sit; whole body bath tub type high buoyancy- half of the body can be immersed, LE/UE Hubbard tank- whole body PARTS: Turbine machine responsible for the production of air Tube- goes further down Propeller- circulates or whirls the water ( tighten machine or loosen up) Of/on button high/low Thermometer- indicate tempt of water, black- dangerous Outlet for drainage of water Overflow drainage- (hose) if water goes up beyond level Can be Movable or fixed Put hot water or use heater if no machine Make sure heater is unplugged, Remove heater first during therapy Adjust tempt- Remove hot water and replace with cold and vice versa PROCEDURE Explain rationale to px Test sensation of px Uses: For pain relief, debridement (removal of dead tissue) -(Presence of heat, motion of the water will lessen the pain) Can do exercises while whirlpool ax Inform px- Mild comfortable warm, warn for burns,vital signs blood pressure (Vasodilatedecrease BP),sensation (test tube hot and cold) Check for contraindication Establish rapport Introduce machine and purpose Position px in comfortable manner Px test the water Place towel on brink to avoid contact and provide comfort If LE (use higher chair) Move knob- to change current of the whirlpool sideways machine up- inc. current (superficial) machine down- inc. current (inner)