PowerPoint® to accompany
Medical Assisting
Chapter 43
Second Edition
Ramutkowski  Booth  Pugh  Thompson  Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
1
Assisting with Cold and Heat
Therapy and Ambulation
Objectives:
43-1 Explain how medical assistants might assist
with some forms of physical therapy.
43-2 Describe ways to test joint mobility, muscle
strength, gait, and posture.
43-3 Discuss the benefits of cold and heat therapies.
43-4 List contraindications to cold and heat therapies.
43-5 Identify various cold and heat therapies.
43-6 Demonstrate how to perform cold and heat
therapies.
2
Assisting with Cold and Heat
Therapy and Ambulation
Objectives (cont.)
43-7 Describe hydrotherapy methods.
43-8 Identify several methods of exercise therapy.
43-9 Compare different methods of traction.
43-10 Demonstrate how to teach a patient to use a cane,
a walker, crutches, and a wheelchair.
3
Introduction

Applying cold and  You may also assist:
heat therapy and
 Applying cold and heat
assisting patients
 Teaching basic exercises
with ambulation are  Demonstrating the use
common duties of a
of cane, walker, and
crutches
medical assistant.
Demonstrating how to use a wheelchair and discussing
specific therapies with the patient for use at home are also
duties that you may be asked to perform.
4
General Principles of
Physical Therapy
Physical therapy is a medical
specialty for treatment of
musculoskeletal, nervous,
and cardiopulmonary
disorders.
5
Assisting with a
Therapeutic Team

Therapeutic team




Physicians
Nurses
Medical assistants
Other specialists
 Coordinate
schedules
 Making referrals
 Explaining
treatment approach
 Documenting
treatments
You must have a working knowledge of
therapy techniques.
6
Assisting with Patient Assessment




Joint mobility testing – range of motion
(degree to which a joint is able to move)
using a goniometer
Muscle strength testing – determine the
amount of force the patient can exert using
a 5-point scale
Gait testing – way a person walks (gait
and swing)
Posture – body position and alignment
7
Cryotherapy & Thermotherapy
Cryotherapy – applying cold to a patient’s body for
therapeutic reasons



Wet or dry
Chemical or natural
Ice packs or bags
Thermotherapy – applying heat to a patient’s body for
therapeutic reasons




Dry heat
Electric pads
Heat lamps
Hot soaks
8
Factors Affecting Use of
Heat and Cold




Age
Treatment location
Circulation or sensation impairment
Temperature tolerance
9
Principles of Cryotherapy
Physiologic responses to cold
include:
 Prevention of swelling by
limiting edema.
 Control bleeding by constricting
blood vessels.
 Lowering body temperature.
 Reduction of pus formation by
inhibiting microorganisms.
 Activity
10
Principles of Thermotherapy

Physiologic responses to heat include:





Relief of pain and congestion
Reduction of muscle spasms
Muscle relaxation
Reduction of inflammation
Reduction of swelling
Chemical Hot/Cold Pack
11
Administering Thermotherapy
 Dry heat




Chemical hot packs
Heating pads
Hot-water bottles
Heat lamps
 Fluidotherapy
 Moist heat
 Hot soaks
 Paraffin bath
12
Administering Thermotherapy
(cont.)
Diathermy – heat therapy in which a
machine produces high frequency waves
that achieve deep heat penetration in
muscle tissue
 Ultrasound
 Shortwave
 Microwave
13
Hydrotherapy
Use of water to treat physical problems
 Whirlpools
 Contrast baths
 Underwater exercises
14
Apply Your Knowledge
The physician has asked you to perform a
moist heat application to a patient’s left leg.
After about 10 minutes of treatment you check
the area and notice it is very red, and the
patient appears to be breathing fast. What
should you do?
15
Apply Your Knowledge -Answer
The physician has asked you to perform a
moist heat application to a patient’s left leg.
After about 10 minutes of treatment you check
the area and notice it is very red, and the
patient appears to be breathing fast. What
should you do?
Remove the application immediately and
take the patient’s vital signs. Report the
results to the physician.
16
Exercise Therapy
 Offer both preventive and therapeutic
benefits
 Primary treatment for fractures,
arthritis, and some respiratory
diseases
17
Exercise Therapy (cont.)

Exercise will help:





Improve muscle tone and
strength
Prevent or correct physical
deformities
Promote neuromuscular
coordination
Improve circulation
Relieves stress
18
Medical Assistant’s Role


Provide information on
various types of
exercise problems and
treatment plan.
Serve as source of
support and
encouragement.


Assist with ROM
exercises.
Teach the patient and
family about ROM
exercises.
19
Type of Exercise






Active mobility – self directed exercises that patient
performs without assistance
Passive mobility – exercises the physical therapist or
machine moves the patient’s body part
Aided mobility – self directed with assistance of a
device such as exercise machine
Active resistance – works against resistance
Isometric – patient relaxes and then contracts muscles
ROM Exercises – moving each joint through its full
range of motions
20
Electrical Stimulation




Devices that deliver controlled amounts of
low-voltage electric current to motor and
sensory nerves to stimulate muscles.
Prevents atrophy in muscles.
Helps in healing injured joints.
Retrain a patient to use injured muscles.
21
Apply Your Knowledge
A patient reports to you that he is having a lot
of muscle aches when he performs his ROM
exercises. What suggestions could you give
him to prevent and treat this problem?
22
Apply Your Knowledge -Answer
A patient reports to you that he is having a lot
of muscle aches when he performs his ROM
exercises. What suggestions could you give
him to prevent and treat this problem?
To prevent the problem he should keep track of the
number or repetitions and amount of weight and
increase each of these slowly. To treat the problem
he should rest and soak in a hot tub.
23
Traction


The pulling or stretching of the
musculoskeletal system to treat fracture bones
and dislocation, arthritic, or other diseased
joints.
May be used to:




Create and maintain bone alignment
Reduce and prevent joint stiffening
Correct deformities
Reduce and relieve muscle spasms
24
Type of Traction
Manual – performed by pulling a patient’s limb by
using you hands.
Static (weight traction) using a harness and weights to
relieve muscle spasms.
Skin – use of foam rubber and weights to prevent injury
to the skin while decreasing muscle spasms.
Skeletal – use pins, wires, or tongs inserted into bones
which are attached to pulleys and weights for
continuous traction.
25
Mobility Aids
Devices to improve patients’ ability to ambulate
 Canes
 Walkers
 Crutches
 Wheelchairs
26
Mobility Aids (cont.)
Canes

Standard


Patient who needs only small
amount of support
Tripod (3 legs) and Quad-base (4
legs)



Create wide base of support
Make them more stable than
standard
Can stand alone, free patient’s hands
when they sit
27
Mobility Aids (cont.)
Walkers



Aluminum frame with four widely placed legs
with rubber tips
Legs are adjustable
Used by older patients who are too weak to
walk unassisted or who have balance
problems
28
Mobility Aids (cont.)
Crutches
 Allow
patient to walk
without putting weight
on the feet or legs by
transferring that weight
to the arms.
 Aluminum or wood
29
Mobility Aids (cont.)
Crutch gaits




Four point – used for slow gait for a patient who
can bear weight on both legs
Three point – used when patient cannot bear
weight on one leg
Two point – used when patient can have some
weight on both legs
Swing point – used when patient has severe
disabilities
30
Mobility Aids (cont.)
Wheelchair



Depends on patient’s disability and length of
time wheel chair needed
You may be responsible for transferring
patient from wheelchair to exam table
Ensure safety for patient and you by
following transfer techniques.
31
Apply Your Knowledge
When would a walker be an appropriate
mobility device for use by your patient?
32
Apply Your Knowledge -Answer
When would a walker be an appropriate
mobility device for use by your patient?
Walkers are used by older patients who are
too weak to walk unassisted or who have
balance problems.
33
Summary
Medical Assistant
You will be asked to help with cryotherapy,
thermotherapy, and other treatments.
You will need to teach a patient how to use mobility
aids.
34
End of Chapter
35