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The American Occupational Therapy Association (AOTA) asserts that physical agent modalities (PAMs) may be used by occupational therapists and occupational therapy assistants in preparation for or concurrently with purposeful and occupation-based activities or interventions that ultimately enhance engagement in occupation (AOTA, 2002, 2003). AOTA further stipulates that PAMs may be applied only by occupational therapists and occupational therapy assistants who have documented evidence of possessing the theoretical background and technical skills for safe and competent integration of the modality into an occupational therapy intervention plan (AOTA, 2003). The purpose of this paper is to clarify the appropriate context for use of PAMs in occupational therapy.
Physical agent modalities are those procedures and interventions that are systematically applied to modify specific client factors when neurological, musculoskeletal, or skin conditions are present that may be limiting occupational performance. PAMs use various forms of energy to modulate pain, modify tissue healing, increase tissue extensibility, modify skin and scar tissue, and decrease edema/inflammation. PAMs are used in preparation for or concurrently with purposeful and occupation-based activities (Bracciano, 2008).
Specific categories of physical agents include superficial thermal agents, deep thermal agents, and electrotherapeutic agents and mechanical devices.
* Superficial thermal agents include but are not limited to hydrotherapy /whirlpool, cryotherapy (cold packs, ice), Fluidotherapy,(TM) hot packs, paraffin, water, infrared, and other commercially available superficial heating and cooling technologies.
* Deep thermal agents include but are not limited to therapeutic ultrasound, phonophoresis, short-wave diathermy, and other commercially available technologies.
* Electrotherapeutic agents use electricity and the electromagnetic...