Role of the PTA
Following examination and evaluation, the physical therapist develops a plan of care which may include goals to minimize the impairments, functional limitations, and disabilities associated with tissue injury. Physical agents use heat/cold, light, water, vibration, current, compression, and stretching stimuli to facilitate functional recovery. Physical agents may also be referred to as "modalities" in the physical therapy plan of care.
Maturity of scar tissue must be taken into consideration when choosing a modality.
The following impairments may be justifications for selecting a biophysical agent to promote tissue healing and recovery.
- decrease pain
- decrease swelling (soft tissue/joint)
- decrease spasm
- increase ROM
- increase strength
- promote tissue/wound healing
A PTA must complete a review of the physical therapy evaluation and related information in the medical record, gather subjective information, and make observations and comparisons in order to select a modality which will optimize recovery. A PTA must be able to distinguish between typical and atypical presentations across a number of systems observations, tests and measures:
- Skin condition (color, blanching, mottling (irregular spots and color), temperature)
- Pain (ratings, location, distribution, quality, localized vs. referred)
- Edema (measurements, subjective/objective impact on function)
- Palpation (soft tissue mobility, tissue sensitivity, pain reproduction)
- Posture (protective, compared to neutral, symmetry)
- Range of motion ( available range, painful range, compensatory movement patterns)
- Muscle strength (pain with applied resistance to muscle)
- Patient comfort and prior experiences with the intervention
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