superficial heat

through epidermis and dermis

• energy or heat being transferred from object to another contacting object to equalize temp
• ex: hotpack or hotpad

• a body part heated or cooled due to moving molecules in liquid or gaseous form
• ex: fluidotherapy or blood from heart warm body

• heated element gives off radiant heat, which can be absorbed by the body if close to the object
• ex: infrared lamp

• intensity of the heat applied
• time of heat exposure
• thermal medium
• depths of heat transfer

• 18
• 6
• <1
• at depth of 3 cm little or no therapeutic change

• increase
• hands wrist foot ankle
• but it will not in big joints such as knee

• 105.8-113 F (41-45 C)
• temp reached in 8-10 min
• in 30 reach equilbrium

• inc metabolism, perspiration, O2 intake
• muscle relaxation
• extensibility of connective tissues coupled with stretching exercises
• inc body temp, pulse rate, respiration, to maintain thermal equibrium

• subacute and chronic inflammation
• muscle injury
• muscle tension (spasm)
• clean ulcers or wounds
• conditions that require relaxation
• pre-treatment modality for exercise, stretching, electrical stim, traction, massage, ultrasound, jt mob

• acute inflammation (strains)
• fever
• malignancis
• active bleeding
• cardiac insufficiences
• very young or old
• PVD
• spasticity
• loss of sensation
• deep vein trombophlebitis

• repeated strong doses
• edema (use mild heat and elevate of extremity recommended)
• confused pt
• pt with poor judgement of heat level

• canvas filled with silicon gel
• delivers heat by conduction
• maintained in water at 158-167 F (70-75 C)

• intensit depends on pt tolerance and and layers of towels
• 6-8 (6-12)layers of towels (commercial cover= 3 towels 5 if envelope contains a sponge insert
• duration 15-20 min
• frequency can be daily or more for subacute problems

• safe
• convenient to treat local areas
• easy to prepare and apply
• inexpensive
• moist, comfortable heat

• may be too heavy for tender areas
• source of infection
• difficult to monitor skin conditions
• unable to control temp once applied
• heat retention dimiishes after 20 min
• passive treatment

• a tank containing medical paraffin and mineral oil
• temp maintained at 129 F (54 C)
• it conducts heat slower than water at the same temp, allowing tissue to heat up more slowly

• 5lbs wax 1pt oil
• 7 parts paraffin to 1 part mineral oil
• adding more oil can lower temp

• used for distal extremities (fingers, hand, wrist, elbows, toes, foot, ankle)
• helps soften skin
• allows even distribution of parts to be treated

• may be too hot
• messy
• limited mvmt
• intracapsular heating may damage articular cartilage in RA
• open wounds can not be immersed

• immersion bath
• dip immersion
• dip and wrap or glove technique

• the pt holds the part in the bath for the duration of treatment.
• this technique produces the greatest heat

• pt dips the part to be treated into tank once or twice and allow to harden, then immerse the part in tank for immersion bath
• skin temp not as high as the immersion bath

imersion is done 6-12 times, the part is then covered with plastic wrap or plastic bag and then with several layers of towel most commonly used least effective for raising skin temp

• duration 20 min
• frequency daily for subacute less for chronic

radiant method of heating with the medium (air) being unaffected

• non luminuos
• and luminous

• long or far, infrared
• wavelength 1,500-15,000 nm
• penetrates 1-2 mm (epidermis)
• source distance 30-36 in at R angle
• warm up 5-10 min
• heat produced by high resistant metal coil

• short, or near infrared
• wavelength 800-1500 nm
• penetrates 10mm (dermis)
• source distance 24-30 in at R angle
• no warm up time
• tungsten filament light bulbs mounted in metal reflectors are the luminous generators
• protect pt eyes
• may feel slightly less heat than non luminuous

the intensity of the waves from a point source varies inversly with the square of the distance from the source

the absorption of rays is optimal when they strike the surface on the perpendicular. as the angle between the beam and teh perpendicular is increased, efficiency is decreased in proportion to the cosine of that angle

may be given once or twice daily for subacute cases and less for chronic

• emits monochromatic infrared photo energy (MIRE) to significantly increase local circulation and temporarily reduce pain
• light emitting diodes (LED's) placed in direct skin contact

• convectional heat, use in providing dry superficial heat that uses very fine cellulose particles through which heated air is blown
• temp stays high the whole time
• temp delivered at 105-125 F (41-52 C)

• single extremity
• bilateral UE/ LE
• entire LE

• exercise both active and passive possible
• constant temp
• wound managemtent if dressed and covered
• particles can be steralized in the unit

• messy
• treatment part not very visible

• subacute may be daily for 20 min
• chronic less time for 20-30 min

• alternate applications of warm (100-110)for 6 min and cold treatment (55-65) for 4 min till a total time of 30 min
• end with either cold or heat based on condition

• alternate constriction and dilation of local blood vessels
• stimulates peripheral blood flow and stimulates healing

• impaired venous circulation
• subacute or chronic traumatic inflammation conditons, transitional treatment
• edema
• sinus or congestive headache (apply to both feet)