SHS.315 Lec-01

PHYSICAL AGENTS AND
ELECTROTHERAPY
SHS.315
RESOURCE PERSON: Mehak Hamna Zahra Gilani

REFERENCE TEXT: JUGMOHAN
SEMESTER: 6 (FALL 2019)
WORK
PLAN
INTRODUCTION
• Physics of heat
• Superficial heating modalities
• Method of application
• Physiological effects
• Contraindications
PHYSICS OF HEAT
Definition of Heat:
Heat is the form of energy associated with vibration of molecules
• Molecules are always in the form of motion
• Which increased as the body gains heat
• And reduced as body looses heat

Temperature :
• The thermal condition of a body which determines the
interchange between it and other bodies. For example,
Normal body temperature is:
37 degrees in Celsius
98.6 degrees in Fahrenheit

PHYSICAL EFFECTS OF HEAT
• Expansion
• Change of state
• Acceleration of chemical action
• Production of difference of potential
• Production of electromagnetic waves
• Reduced viscosity
TRANSMISSION OF HEAT
• Conduction
• Convection
• Radiation
CONDUCTION
• Heat is transmitted by conduction between objects which are in-
contact with each other and between different parts of one object
• It occurs more readily in objects that are good conductors like metal
CONVECTION
• Transmitted in liquid or gas
• Molecules vibrate more vigorously and fly apart
• Fluid expands and its density becomes less
• Convection currents set up and transfer heat from one part to another
RADIATION
• Hot object emits infra-red and possibly also visible and ultraviolet rays
• Travel away from the point at which they are produced until they
encounter some medium which absorbs them
• When they are absorbed – heat is produced

Superficial Heating Modalities
• Hydrocollator hot packs
• Whirlpool bath
• Contrast bath
• Sauna bath
• Heliotherapy
Hydrocollator Hot Packs
The hydro-collator unit is a stainless steel tank in which silica gel packs are
heated.
The capacities of the machines vary, and all units have insulated bases, the
larger machines being insulated with fiberglass.
The units contain a wire rack which acts as divider for the packs and prevents
contact of packs with the bottom of the tank.

HYDROCOLLATOR
The heater is thermostatically controlled and maintains water in the unit at a
temperature between 65°C and 80°C.
It can be left on continuously as long as there is enough water in the tank.
A hydro collator pack is a fabric envelope containing silica gel.
The main property of the gel is its capability to absorb many times its
own volume of water and when heated, to give moist heat for 30 to
40 minutes. The packs are heated in a hydro-collator unit.
Packs come in various sizes and shapes

The packs last about six months.
When they begin to wear out the filler leaks out and makes the water
cloudy; they should then be replaced

• It provides superficial moist heat
• Way of transferring heat to the patient by conduction
• Heating unit is called hydrocollator
• It raises body temperature to 40-45 degree celcius

Technique of Application
Physiological Effects of Hydro-collator Packs
1. Heat production
2. Temperature Elevation
3. Local increase in temperature
4. Subcutaneous tissue and muscles temperature
5. Hyperemia
Indirect effect of Heating
• Effect on muscle tissues
• General increase in temperature
• Fall in Blood pressure
• Increased activity of Sweat Glands

Therapeutic Effects
• Relief of pain
• Increase in ROM
• Breakage of Adhesions
• Softening of Scar tissue
• Decrease Muscle Spasm
• Improve Body Functions

Contra-indications for Hydrocollator Packs:
1. Impaired Skin Sensation

2. Circulatory dysfunction
3. Analgesic drugs
4. Infections and open wounds
5. Cancer and Tuberculosis
6. Gross Oedema
7. Lack of Comprehension
8. Deep X-Ray Therapy
Advantages:
1. A hydro-collator pack is easy to apply; it saves time for personnel and is
efficient in heat conduction depending on the area treated.
2. The packs are of various sizes which fit most clinical needs.
3. Moist heat has a more sedative effect than dry heat.
4. Maximal temperatures are more uniform than in electrically-heated pads.
5. The patient does not need much handling.
6. The pads can be laid out ready for the patient to place on the affected part.
Disadvantages:
1. A hydro-collator pack is not easily applied around shoulders and
hips. It is somewhat heavy and should not be used on extremely
sensitive patients, since it can create discomfort.
2. Sometimes moist packs have a tendency to cause a skin rash.

Electric Heating Pad
• Temperature – 40 – 45 degree C
• Electric heating element regulated by resistor/rheostat

Evidence:
• Circulation plays an essential role in tissue healing. Moist heat and warm
water immersion have been shown to increase skin circulation.
• Moist heat produced the greatest increase in skin blood flow and the
second highest increase in skin blood flow nine minutes post application.
• Reference:
Lohman III, E. B., et al. (2011). "A comparison of the effect of a variety of thermal and vibratory modalities on skin temperature and
blood flow in healthy volunteers." Medical science monitor: international medical journal of experimental and clinical research 17(9):
MT72.
Clinical application:
• Used as a first protocol of treatment in all scenarios except
contraindications
• To relax patient
• To decrease pain
• To make patient more approachable
• Must be applied in patient preferred relaxing position
• Although lying supine or prone is considered most comfortable
positions.
• No hard and fast rule on the shape of hot pack and its application
Clinical case:
• Mr Jones is a 45 year old male who has low back pain for 2 weeks. He
states that pain radiates to right leg and also reports of tingling and
numbness sensation in right leg. He describes that pain increases with
activity and decrease with rest.
• To develop the treatment plan for this patient first of all you have to
apply hot pack at the lumber region for about 15 to 20 mins before
incorporating any other therapy just to provide patient some pain
relief and relaxation which will be helpful in further treatment
process.
SUMMARY
• Physics of heat
• Superficial heating modalities
• Paraffin wax bath therapy
• Method of application
• Physiological effects
• Contraindications
QUIZ
• Which of the following is not a superficial heating modality?
• Hot Packs
• Short Wave diathermy
• Whirlpool therapy
• Sauna Bath
QUIZ
• Which of the following is not a superficial heating modality?
• Hot Packs
• Short Wave diathermy
• Whirlpool therapy
• Sauna Bath
QUIZ
• In a hydrocollator temperature is maintained at
• 65°C and 80°C.
• 75°C and 80°C.
• 55°C and 80°C.
• 60°C and 80°C.

QUIZ
• In a hydrocollator temperature is maintained at
• 65°C and 80°C.
• 75°C and 80°C.
• 55°C and 80°C.
• 60°C and 80°C.

QUIZ
• Way of transfer of heat in a hot pack?
• Conduction
• Convection
• Radiation
QUIZ
• Way of transfer of heat in a hot pack?
• Conduction
• Convection
• Radiation

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PHYSICAL AGENTS AND

RESOURCE PERSON: Mehak Hamna Zahra Gilani

• Superficial heating modalities

Heat is the form of energy associated with vibration of molecules

• Molecules are always in the form of motion

• Which increased as the body gains heat

• And reduced as body looses heat

• The thermal condition of a body which determines the

interchange between it and other bodies. For example,

Normal body temperature is:

98.6 degrees in Fahrenheit

• Acceleration of chemical action

• Production of difference of potential

• Production of electromagnetic waves

• Heat is transmitted by conduction between objects which are in-

• Transmitted in liquid or gas

• Molecules vibrate more vigorously and fly apart

• Fluid expands and its density becomes less

encounter some medium which absorbs them

• When they are absorbed – heat is produced

• Hydrocollator hot packs

larger machines being insulated with fiberglass.

contact of packs with the bottom of the tank.

The heater is thermostatically controlled and maintains water in the unit at a

temperature between 65°C and 80°C.

A hydro collator pack is a fabric envelope containing silica gel.

40 minutes. The packs are heated in a hydro-collator unit.

Packs come in various sizes and shapes

The packs last about six months.

cloudy; they should then be replaced

• It provides superficial moist heat

• Way of transferring heat to the patient by conduction

• Heating unit is called hydrocollator

• It raises body temperature to 40-45 degree celcius

3. Local increase in temperature

4. Subcutaneous tissue and muscles temperature

• Effect on muscle tissues

• General increase in temperature

• Fall in Blood pressure

• Increased activity of Sweat Glands

• Softening of Scar tissue

• Decrease Muscle Spasm

• Improve Body Functions

1. Impaired Skin Sensation

1. A hydro-collator pack is easy to apply; it saves time for personnel and is

efficient in heat conduction depending on the area treated.

3. Moist heat has a more sedative effect than dry heat.

4. Maximal temperatures are more uniform than in electrically-heated pads.

5. The patient does not need much handling.

1. A hydro-collator pack is not easily applied around shoulders and

hips. It is somewhat heavy and should not be used on extremely

sensitive patients, since it can create discomfort.

2. Sometimes moist packs have a tendency to cause a skin rash.

• Electric heating element regulated by resistor/rheostat

• Superficial heating modalities

• Paraffin wax bath therapy

• Which of the following is not a superficial heating modality?

• Short Wave diathermy

• Which of the following is not a superficial heating modality?

• Short Wave diathermy

• In a hydrocollator temperature is maintained at

• 65°C and 80°C.

• 75°C and 80°C.

• 55°C and 80°C.