Lecture Clinical procedures for medical assisting (4/e): Chapter 11 – Booth, Whicker, Wyman

CHAPTER

11
Assisting with Cold
and Heat Therapy
and Ambulation
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11­2

Learning Outcomes
11.1 Explain how medical assistants might assist with
some forms of physical therapy.
11.2 Describe ways to test joint mobility, muscle strength,
gait, and posture.
11.3 Discuss the benefits of cold and heat therapies.
11.4 List contraindications to cold and heat therapies.
11.5 Identify various cold and heat therapies.

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11­3

Learning Outcomes (cont.)
11.6 Demonstrate how to perform cold and heat
therapies.
11.7 Describe hydrotherapy methods.
11.8 Identify several methods of exercise therapy.
11.9 Compare different methods of traction.

11.10 Demonstrate how to teach a patient to use a cane, a
walker, crutches, and a wheelchair.

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11­4

Introduction
• Medical assistant
– Common duties
• Apply cold and heat
therapy
• Assist patients with
ambulation

• You may also
– Teach basic
exercises
– Demonstrate how
to use a wheelchair
– Demonstrate the
use of cane,
walker, and
crutches
– Discuss therapies
with the patient
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

11­5

General Principles of Physical Therapy
• Physical therapy is a
medical specialty that
treats
– Musculoskeletal
disorders
– Nervous disorders
– Cardiopulmonary
disorders

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General Principles of Physical Therapy

11­6

(cont.)

• Assisting the therapeutic team
– Members
•
•
•
•

Physicians
Nurses

Medical assistants
Other specialists

 You must have a 

working knowledge of 
therapy techniques.

– Coordinate patient
schedule
– Make referrals
– Explain treatment
approach
– Documentation
– Reinforce instructions
– Answer patient
questions
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General Principles of Physical Therapy

11­7

(cont.)

• Specialized
therapies
– Art
– Music

– Dance
– Writing

– Crafts
– Aquatic
– Horticultural
– Equestrian

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11­8

Patient Assessment
• Joint mobility testing
– Range of motion (ROM) – degree to which a joint
is able to move
– Goniometer
– Degree of movement
compared to a standard
measure

• Muscle strength testing
– Determines the amount of force the patient can
exert with a group of muscles
– Compare each side of body
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11­9

Patient Assessment (cont.)
• Gait testing
– The way a person
walks (gait and
swing)
– Includes
•
•
•
•

Length of stride
Balance
Coordination
Direction of
knees and feet

• Posture
– Body position and
alignment
– Checks spinal
curves
– Symmetry of
alignment
• Shoulders
• Knees
• Hips
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.

11­10

Apply Your Knowledge
Match description with assessment type:

ANSWER:

___
D How a person walks

A. Joint mobility

A Range of motion
___

B. Muscle strength

C Body position and alignment
___

C. Posture

B Force exerted with a group of muscles D. Gait
___
A Goniometer
___
C Check spinal curves
___
D Length of stride

___

Good Job!

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


11­11

Cryotherapy and Thermotherapy
• Cryotherapy

• Thermotherapy

– Applying cold for
therapeutic
reasons

– Applying heat for
therapeutic
reasons

– Types

– Types

• Wet or dry

• Dry

• Chemical or natural

• Moist

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Cryotherapy and Thermotherapy

11­12

(cont.)

• Generally promote
healing
• Side effect – damage
to underlying nerves
and tissues
• Monitor patient
closely

• Factors affecting the
use of these
treatments
– Treatment location
– Circulation or
sensation impairment
– Temperature tolerance
– Age

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11­13

Principles of Cryotherapy
• Constricts blood vessels
• Physiologic responses to cold
– Prevents swelling
– Controls bleeding
– Reduces
inflammation

– Anesthetic effect for
pain
– Reduces pus
formation
– Lowers body
temperature
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11­14

Administering Cryotherapy
• Dry cold applications
– Ice bags and collars
– Chemical ice packs

• Wet cold applications

– Cold compresses
– Ice massage

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11­15

Principles of Thermotherapy
• Dilates blood vessels
• Physiologic responses to heat
– Relieves pain and congestion
– Reduces muscle spasms
– Muscle relaxation
– Reduces inflammation
– Reduces swelling

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


11­16

Administering Thermotherapy
• Dry heat therapies
– Chemical hot packs
– Heating pad

– Hot-water bottle
– Heat lamp
– Fluidotherapy

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11­17

Administering Thermotherapy (cont.)
– Moist heat applications
•
•
•
•

Hot soak
Hot compress
Hot pack
Paraffin bath

– Diathermy – highfrequency wave
achieves deep heat
penetration
• Ultrasound
• Shortwave
• Microwave

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11­18

Apply Your Knowledge
What is the main difference in the effect of
cryotherapy and thermotherapy that results in the
physiologic response of each?
ANSWER: Cryotherapy causes blood vessels to
constrict, resulting in its physiologic effects, while
thermotherapy causes blood vessels to dilate.

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11­19

Hydrotherapy
• Use of water to treat physical
problems
• Whirlpools
– Water is agitated by jets of air
under pressure
– Generates hydromassage
• Relaxes muscles
• Increases circulation

– Also used to clean and debride
wounds, ulcers, and burns
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11­20

Hydrotherapy (cont.)
• Contrast baths

– 2 baths, one hot
and one cold
– Patient moves
quickly from one to
the other
– Purpose

• Induces relaxation
• Improves circulation
• Greater mobility

• Underwater
exercises
– Warm swimming
pool
– Buoyancy takes
pressure off joints
– Purpose
• Promotes relaxation
• Increases
circulation

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


11­21

Apply Your Knowledge
What are the main effects of hydrotherapy?

ANSWER: Hydrotherapy relaxes muscles, increases
circulation, and improves flexibility and mobility.

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.


11­22

Exercise Therapy
• Preventive and therapeutic benefits
–
–
–
–

Flexibility
Mobility
Muscle tone
Strength

• Primary treatment for fractures,
arthritis, and some respiratory
diseases
– Minimizes symptoms
– Slows disease progression
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11­23

Exercise Therapy (cont.)
• Exercise
– Improves muscle tone
and strength
– Maintains ROM

– Improves circulation

– Prevents or corrects
physical deformities

– Relieves stress

– Promotes
neuromuscular
coordination

– Lowers cholesterol
levels
– Aids in resumption of
normal daily activities

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11­24

Medical Assistant’s Role
• Provide patient
information
– Types of exercise
programs
– Treatment plan



Assist with ROM 
exercises



Teach the patient and 
family about ROM 
exercises.

• Provide support and
encouragement

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11­25

Types of Exercise
• Choice based on patient’s
physical condition
• Active mobility

– Self-directed exercises
– Increase muscle strength
and function

• Passive mobility
– Therapist or machine
moves the patient’s body
part
– Retain ROM and improve
circulation

• Aided mobility
– Self-directed with
assistance of a device such
as exercise machine
– Retain or improve ROM

© 2011 The McGraw-Hill Companies, Inc. All rights reserved.