superficialheatingmodalities

8/7/2019 SuperficialHeatingModalities

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Superficial Heating Modalities


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Superficial vs Deep HeatingAgents

Superficial

Primarily causes increases in skin temp and

superficial subcutaneous tissue

Depths of penetration


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Biophysical Effects ofSuperficial Heat

Magnitude of tissue temperaturechanges depends on

The extent of tissue temp rise

Therapuetic levels = 104-113 skin temp

Above or below?

The rate energy is added to tissue

Too fast or too slow

The volume of tissue exposed

Larger volume more chances for systemic

changes


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Physiological Responses toTissue Heating

Metabolic Reactions

2xs metabolic rate =106o F

Enzymatic activity increases = 102o F

>122 = rapid decrease

Oxygen uptake?

Vascular Effects Vasodilation

Importance of Skin BF during Heating

Local and reflexive mechanisms


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Physiological Responses toHeating

Vascular cont.

Axon Reflex

Cutaneous receptors Some afferents go to

SC

Others go directly tovessel receptors


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Physiological Responses toHeating

Vascular cont.

Local Spinal Reflex

Activated viacutaneous receptors

Decreases nerveactivity of smoothmuscle tissue

Importance ofSkeletal Muscle BFduring Heating


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Neuromuscular Effects

Provides analgesia to assist with pain relief

and muscle guarding

Heat can

Elevate pain threshold

Alter nerve conduction velocity

Change muscle spindle firing rates?

Temporarily change tension producingcharacteristics in muscle


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Connective Tissue Effects

Superficial heat alone will NOT alter

viscoelastic properties of tissue Heat and stretch together

Result = plastic elongation of deeper tissue

Two factors important determining treatment

strategies

Temperature elevation

Stretch


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Heating Agents


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Conductive Heating Agents

Hot packs Superficial moist

heat

Placementconsiderations

Depth of Penetration

Tx time

Advantages anddisadvantages

Precautions


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Conductive Heating Agents

Paraffin Wax BathTreatment

Low Melting Point Low Specific Heat

Rationale for Use

Application Techniques Dip and Wrap

Dip and Immerse

Tx Time

Advantage &Disadvantages

Precautions


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Convective Heating Agents

Fluidotherapy

Dry heating agent

Viscosity low

Provide high heatfluxes and strongmassaging action

Heat Control

Fluidotherapy vsParaffin Wax

Advantages &Disadvantages


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Radiating Heating Agents

Infrared Heat Lamps

Not commonly used

Very superficial 1-10 mm DOP

Two types

Luminous

Non-luminous

Setup

Inverse Square Law

Cosine Law

Tx Time


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Clinical Implications forSuperficial Heat

Trunk, shoulder, hip or knee consideredmild heating

Mild vs Vigorous


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Mild vs Vigorous Heat


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Surface Temperature Rangesand Subjective Feelings


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Clinical Implications forSuperficial Heat

Trunk, shoulder, hip or knee considered mildheating

Mild vs VigorousPain and Muscle Spasm

Improving ROM

Tissue Healing

Subacute and Chronic Conditions Hematoma resolution

Joint contractures


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Contraindications toSuperficial Heating

Poor or reduced sensation

Vascular insufficiency

Vascular Disease

Acute injuries

Malignancy

Application over where liniments havebeen applied


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Heat vs Cold therapyFactors to consider Stage of healing

Heat Advantages

Decr pain, incr tissue extensibility, decr stiffness Disadvantages

May incr swelling

Cold Advantages

Prevent further swelling, decr pain Disadvantage

Incr stiffness, decr tissue extensibility

Areas of body treated

Medical status

Patient preference

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