Skip to Main Content

Physical therapists, athletic trainers, occupational therapists, physical therapy assistants, occupational therapy assistants, physical therapy aides, and chiropractors use a wide variety of therapeutic techniques in the treatment and rehabilitation of their patients. A thorough treatment regimen oft en involves the use of therapeutic modalities. At one time or another, virtually all clinicians make use of some type of modality. This may involve a relatively simple technique such as using an ice pack for an acute injury or more complex techniques such as the stimulation of nerve and muscle tissue by electrical currents. There is no question that therapeutic modalities are useful tools in injury rehabilitation. When used appropriately, these modalities can greatly enhance the patient's chances for complete recovery. Unfortunately, the clinicians' rationale for using a particular modality is too oft en based on habit rather than on logic or analysis of effectiveness. For the clinician, it is essential to possess knowledge regarding the scientific basis and the physiologic effects of the various modalities on a specific injury. When this theoretical basis is applied to practical experience, it has the potential to become an extremely effective clinical method.

It must be emphasized that the use of therapeutic modalities in any treatment program is an inexact science. If you were to ask 10 different clinicians what combination of modalities and therapeutic exercise they use in a given treatment program, you would likely get 10 different responses. There is no way to "cookbook" a treatment plan that involves the use of modalities. Thus, what this book will attempt to do is to present the basis for use of each different type of modality and allow the clinician to make his or her own decision as to which will be most effective in a given situation. Some recommended protocols developed through the experiences of the contributing authors will be presented.

The following are a number of reasons why this text should be adopted for use.

Comprehensive Coverage of Therapeutic Modalities Used in a Clinical Setting

The purpose of this text is to provide a theoretically based but practically oriented guide to the use of therapeutic modalities for the practicing clinician and their students. It is intended for use in courses where various clinically oriented techniques and methods are presented.

The chapters in this text are divided into six parts. Each chapter discusses (1) the physiologic basis for use, (2) clinical applications, (3) specific techniques of application through the use of related laboratory activities, and (4) relevant individual case studies for each therapeutic modality.

Part I—Foundations of Therapeutic Modalities begins with a chapter that discusses the scientific basis for using therapeutic modalities and classifies the modalities according to the type of energy each uses. Guidelines for selecting the most appropriate modalities for use in different phases of the healing process are presented. A chapter that deals specifically with the role of therapeutic modalities in wound healing is followed by a discussion of pain in terms of the neurophysiologic mechanisms of pain and the role of therapeutic modalities in pain management.

Part II—Electrical Energy Modalities includes detailed discussions of the principles of electricity, and electrical stimulating currents, iontophoresis, and biofeedback. A chapter that deals with the principles of electrophysiologic evaluation and testing is included. Although this is not a therapeutic modality per se, electrophysiologic testing is commonly taught in classes that cover electrical modalities and thus the decision was made to include this topic in this text.

Part III—Thermal Energy Modalities discusses those modalities that produce a change in tissue temperatures through conduction, including thermotherapy and cryotherapy.

Part IV—Sound Energy Modalities discusses those modalities that utilize acoustic energy to produce a therapeutic effect. These include therapeutic ultrasound and a lesser known modality, extracorporal shockwave therapy.

Part V—Electromagnetic Energy Modalities includes chapters on both the diathermies and low-level laser therapy.

Part VI—Mechanical Energy Modalities includes chapters on traction, intermittent compression, and therapeutic massage.

Based on Scientific Theory

This text discuses various concepts, principles, and theories that are supported by scientific research, factual evidence, and previous experience of the authors in dealing with various conditions. The material presented in this text has been carefully researched by the contributing authors to provide up-to-date information on the theoretical basis for employing a particular modality in a specific injury situation. Additionally, the manuscript for this text has been carefully reviewed by educators, researchers, and practicing clinicians who are considered experts in their field to ensure that the material reflects factual and current concepts for modality use.

Timely and Practical

Certainly, therapeutic modalities used in a clinical setting are important tools for the clinician. This text provides a comprehensive resource that should be used in student instruction on the theoretical basis and practical application of the various modalities. It should serve as a needed guide for the student who is interested in knowing not only how to use a modality but also why that particular modality is most effective in a given situation.

The authors who have contributed to this text have a great deal of clinical experience. Each of these individuals has also at one time or another been involved with the formal academic preparation of the student clinician. Thus, this text has been directed at the student who will be asked to apply the theoretical basis of modality use to the clinical setting.

Several other texts are available that discuss the use of selected physical modalities in various patient populations. This is the most comprehensive text on therapeutic modalities available in any specific discipline.

Pedagogic Aids

The aids this text uses to facilitate its use by students and instructors include:

Objectives These goals are listed at the beginning of each chapter to introduce students to the points that will be emphasized.

Figures and Tables Essential points on each chapter are illustrated with clear visual materials.

Summary Each chapter has a summary that outlines the major points covered.

Clinical Decision-Making Exercises The scenarios help the clinician develop decision-making abilities about how a specific modality may best be used clinically.

Review Questions Designed to help the student review the material presented in each chapter by answering a series of thought-provoking questions.

Self-Test Questions A set of true/false and multiple choice questions is provided to help the student prepare for a written examination and to assess student comprehension.

Glossary of Key Terms A glossary of terms is available for quick reference.

References A list of up-to-date references is provided at the end of each chapter for the student who wishes to read further on the subject being discussed.

Case Studies A series of clinically based case studies are presented to enhance student understanding of how these modalities may be applied to a specific patient.

Lab Activities Lab activities are included to guide the student through the setup and application of the various modalities.

Appendices A chart of trigger points and a list of units of measure are provided.

How to Use the Laboratory Activities

There are a wide variety of laboratory activities found throughout this book.

Theory, biophysical principles, and range of potential clinical medicine applications for the various physical agent modalities will be found in this text. The activities are intended to provide the student or interested reader with a systematic and sequential method of completing a therapeutic modality application. The initial performance of a therapeutic procedure should proceed in a logical stepwise fashion. They are structured to allow both the instructor or supervisor and the student the ability to assess competency in a partial or complete fashion culminating in the independent ability to safely and effectively provide a therapeutic modality treatment.

Each therapeutic modality application has a separate sequential checklist. Similarities will be noted in certain aspects of treatment application and completion. Space is provided for up to three separate instructors/supervisors to "sign off" (initial and date) the successful completion and demonstration of each element of the complete application. A Master Competency Check List is provided to document the successful completion of the individual therapeutic modality checklist and when the student is deemed competent to independently provide that treatment. This system documents the acquisition of skills necessary for effective physical agent modality application and ensures accountability by the student and instructor/supervisor to patients and other concerned parties.

Competency in the skillful application of therapeutic modalities is gained through diligent and frequent practice. Use of these activities in the manner described will guide the user in productive practice and successful acquisition of essential skills. Students are encouraged to practice each of the procedures on themselves first, thereby gaining an appreciation of the sensations associated with that particular modality. Further practice with a variety of lab partners will result in the development of the desired competence and confidence with any manufacturer's equipment.

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.