Evidence-Based Physical Agents: Application and Practice

This 30 hour course is an evidence-based presentation focusing on the clinical application of physical agents and modalities. Participants will have the opportunity to learn through lecture, case-based discussions and hands-on lab experiences.

The application of ultrasound, diathermy, laser and electrical stimulation will be discussed and practiced – based on current trends, expected tissue response, clinical goals and the current literature studies. This will be an active learning environment and participants will be encouraged to participate in discussions and come dressed for the lab applications.

Goals:
This course will provide instruction on the:

  • Principles of physics related to specific properties of light, temperature, sound and electricity.
  • Physiological, neurophysiological and electrophysiological changes as indicated, which occur as a result of modality application.
  • Normal and abnormal tissue response to the application of each modality.
  • Application, indications, contraindications, safety rules and precautions related to the selection and application of ultrasound, diathermy, laser and electrical stimulation.
  • Guidelines for educating clients, including instructing about the process and possible outcomes of treatment, including the risks and benefits related to the application of ultrasound, diathermy, laser and electrical stimulation.
  • Methods of documenting the effectiveness of the immediate and long-term effects of treatment.
  • Characteristics of the equipment, including safe operation, adjustment and care of the equipment.

Program subject to change. During hands-on lab sessions, course instructor(s) will evaluate each participant’s techniques/skills learned to determine proficiency for course completion. Post test at end of course will assess your new knowledge.

This course content is not intended for use by any participants outside the scope of their license or regulation.

Course Objectives:

Participants will be able to:

  • understand how to properly inform patients regarding treatment outcomes, risks and benefits of application of ultrasound, diathermy, laser and electrical stimulation through case-based discussion and role playing applications during lab sessions
  • discuss the principles of physics for the application of ultrasound, diathermy, laser and electrical stimulation during each hands-on lab session.
  • apply the principles of physics when choosing proper parameters during application of ultrasound, diathermy, laser and electrical stimulation through case based discussions.
  • discuss and safely apply the proper and safe treatment parameters for the application of ultrasound, diathermy, laser and electrical stimulation based on each modalities physiological, neurophysiological and/or electrophysiological response during the case-based discussions.
  • discuss whether use of ultrasound, diathermy, laser and electrical stimulation is indicated or contraindicated through case-based discussions and lab applications.
  • discuss whether use of ultrasound, diathermy, laser and electrical stimulation is indicated or contraindicated through case-based discussions and lab applications.
  • demonstrate proper application of each modality based on the current literature, tissue response and proper indication during the hands-on labs.
  • properly document treatments involving ultrasound, diathermy, laser and electrical stimulation during the hands-on lab.
  • discuss and apply safe and effective parameters during case-based discussion and hands-on lab applications
  • demonstrate proper operation and care for each modality unit during the hands-on lab.

CE Credits

30 contact hours

Participation in this class depends on your State Practice Act.

This course is accepted by many professional credentialing organizations and state professional regulatory boards. Rules and regulations change frequently without notification, and apply differently to live and online courses. Please check with your state board to confirm accuracy of this list and acceptance of contact hours. Certificate of Attendance will be issued to all participants upon completion of the course and may be used for CEU verification of credits. CE credits vary by state. Please check with your state board/certifying agency to confirm conversion of contact hours to CE. See links below.

 

Physical Therapy Board of California: The Physical Therapy Board of California recognizes Rehab Education, LLC as an approval agency to approve providers offering continuing competency courses for CA licensed PTs and PTAs. This course is approved for 30 contact hours.

Illinois State Board of Physical Therapy: Approved CE Sponsor by Illinois State Board of Physical Therapy, Division of Professional Regulations, Approval #216.000227. (Course must be taken prior to 09-30-2020)

NY State Physical Therapy Board: Rehab Education, LLC is recognized as an approved provider of PT and PTA continuing education by the NY State Education Department Board of Physical Therapy. (Course must be taken prior to 05-10-2022)

American Occupational Therapy Association (AOTA) Approved Provider #6177: See states that currently recognize AOTA Approved Providers for OT

  • AOTA Approval States

    These states currently recognize AOTA Approved Providers for OT continuing education either in regulatory language or by formal written communication to AOTA:

    Alaska
    Arkansas
    Delaware
    District of Columbia
    Illinois
    Indiana
    Kentucky
    Louisiana
    Maryland
    Minnesota
    Mississippi
    Missouri
    Montana
    Nevada
    New Hampshire
    New York
    North Carolina
    North Dakota
    Ohio
    Oregon
    Oklahoma
    Pennsylvania
    Rhode Island
    South Carolina
    Tennessee
    Texas
    Vermont
    Virginia

    *Disclaimer: Rehab Education LLC provides this list for your convenience. At the time of listing, the following state boards accept courses by virtue of approval by other organizations. It is the responsibility of the participant registering for a course to check with their state board to confirm rules and regulations regarding acceptance of contact hours for live and online courses.

    The following PT Boards accept courses approved by other state PT boards or APTA state associations*:

    Georgia
    Kentucky
    Montana
    North Carolina
    Oregon
    Virginia

    The following PT Boards accept courses approved by other APTA state associations*:

    Arizona
    Florida
    Indiana
    Mississippi
    Missouri
    Rhode Island
    Utah
    Vermont
    Wisconsin

    The following PT Boards accept courses provided by AOTA approved providers*:

    Arizona
    District of Columbia
    Rhode Island

    HELPFUL LINKS:
    *NBCOT…National Board for Certification of Occupational Therapy (view PDU requirements)

    +HTCC… Hand Therapy Certification Commission  (view recertification requirements)
    Hand Therapy Certification Commission (HTCC): This course is accepted by HTCC towards re-certification.

    State PT Boards
    State OT Boards

Agenda:

This course is taught in two formats: as a 4 day course, or as a three day course. Course content is the same for both versions of the course.

3-Day Agenda

Hours for the 3 day course are from 8am to 8pm, with registration beginning at 7:30am each day.

Day 1

7:30 – 8:00 Registration
8:00 – 10:15
  • Ultrasound:
    • What is Ultrasound?
    • Why would we apply Ultrasound?
    • Ultrasound Terminology
    • Principles of physics related to specific properties of sound
    • Physiological, neurophysiological and electrophysiological changes, as indicated, which occur as result of the application of Ultrasound
    • Normal tissue and abnormal tissue response
    • Guidelines for educating clients, including instructing about the process and possible outcomes of treatment, including the risks and benefits of Ultrasound application
    • Safety rules and precautions related to Ultrasound application
    • Indications / Contraindications
  • Lab Activity (hands-on)
    • Introduction to the ultrasound unit
    • hands-on application of each modality by each course participant
    • Characteristics of the equipment, including safe operation, adjustment and care of the equipment
    • skills including but not limited to:
      • powering on the unit
      • proper cleaning / maintenance
      • cleaning the transducer/ultrasound head
      • gel application
      • movement of the sound head
10:00 – 10:15 Break
10:15 – 12:15
  • Ultrasound
    • Methods of documenting the effectiveness of the immediate and long-term effects of treatment
    • Ultrasound literature review
  • Lab Activity (Hands-on)
    • hands-on application of each modality by each course participant
    • Application of Ultrasound to increase tissue temperature (1oC, 2 oC, 4 oC)
    • Application of pulsed ultrasound for cellular effects and phonophoresis
12:15 – 1:00 Lunch on your own
1:00 – 2:00
  • Lab Activity (Hands-on)
    • Clinical cases for application of ultrasound
    • Written Ultrasound proficiency test / discussion
2:00 – 3:00
  • Diathermy
    • What is Diathermy?
    • Why should we use Diathermy?
    • Diathermy terminology (i.e.: shortwave, microwave, eddy currents)
    • History of Diathermy
3:00 – 3:15 Break
3:15 – 6:15
  • Principles of physics related to specific properties of diathermy
  • Physiological, neurophysiological and electrophysiological changes, as indicated, which occur as a result of the application of diathermy
  • Normal tissue and abnormal tissue response
  • Guidelines for educating clients, including instructing about the process and possible outcomes of treatment, including the risks and benefits of Ultrasound application
  • Safety rules and precautions related to diathermy application
  • Methods of documenting the effectiveness of the immediate and long-term effects of treatment
  • Indications / Contraindications
  • Review of the Literature Lab Activity
  • hands-on application of each modality by each course participant
  • Setup / parameter adjustment
  • Case Discussion / application
  • Written Diathermy proficiency test / discussion
6:15 – 7:00 Dinner Break
7:00 – 8:00
  • Laser / Light Therapy
    • What is Laser / LED / Cold Laser?
    • Why would we use Light Therapy?
    • Laser Terminology (i.e: wavelength, LED, photo receptors
8:00 Adjourn/Sign Out

Day 2

7:30 – 8:00 Registration
8:00 – 9:00
  • Ultrasound Lab Activity
    • Case discussion and application of ultrasound
9:00 – 10:15
  • Light Therapies / Laser
    • Principles of physics related to specific properties of light wave therapy
    • Physiological, neurophysiological and electrophysiological changes, as indicated, which occur as a result of the application of light wave therapies
    • Normal tissue and abnormal tissue response
    • Guidelines for educating clients, including instructing about the process and possible outcomes of treatment, including the risks and benefits of light wave therapy application
    • Safety rules and precautions related to light wave therapy application
    • Indications / Contraindications
10:15 – 10:30 Break
10:30 – 12:15
  • Light Therapies
    • Methods of documenting the effectiveness of the immediate and long-term effects of treatment
  • Lab Activities
    • hands-on application of each modality by each course participant
    • Setup / parameter adjustment
    • Case Discussion / application
    • Light therapy proficiency test / discussion
    • Review of the Literature

Written Ultrasound proficiency test / discussion

12:15 – 1:00 Lunch on your own
1:00 – 3:00
  • Electrical Stimulation
    • What is Electrical Stimulation?
    • Why would we use Electrical Stimulation?
    • Electrical Stimulation Terminology (pulse duration, frequency, hertz)
    • History of Electrical Stimulation

Review of the literature

3:00 – 3:15 Break
3:15 – 5:45
  • Electrical Stimulation
    • Principles of physics related to specific properties of Electric Stimulation
    • Physiological, neurophysiological and electrophysiological changes, as indicated, which occur as result of the application of Electric Stimulation
    • Normal tissue and abnormal tissue response
    • Guidelines for educating clients, including instructing about the process and possible outcomes of treatment, including the risks and benefits of Electric Stimulation application
    • Safety rules and precautions related to Electric Stimulation application
    • Methods of documenting the effectiveness of the immediate and long-term effects of treatment
    • Indications / Contraindications
5:45 – 6:30 Dinner Break
6:30 – 8:00

Electrical Stimulation

  • Lab Activities
    • hands-on application of each modality by each course participant
    • Setup / parameter adjustment
    • Finding motor points
8:00 Adjourn/ Sign Out

Day 3

7:30 – 8:00 Registration
8:00 – 10:00
  • Electrical Stimulation
    • Review Indications / Contraindications
    • Introduction to TENS
    • Sensory
    • Acupuncture-like
    • Burst
  • Lab Activities
    • hands-on application of each modality by each course participant
    • Setup / parameter adjustment
    • Case Discussion / application
10:00 – 10:15 Break
10:15 – 12:15
  • Electrical Stimulation
    • Pain Control Theories
    • Theories on muscle contraction
    • Strengthening Principles
    • Introduction to Functional Electrical Stimulation
  • Lab Activities
    • hands-on application of each modality by each course participant
    • Setup / parameter adjustment
    • Case Discussion / application
    • Motor point application for specific upper extremity muscle contraction 3/5 Manual Muscle Grade
12:15 – 1:00 Lunch on your own
1:00 – 3:00
  • Electrical Stimulation
    • Line powered Unit
    • High Volt
    • Premodulated Current
    • Interferential Current
    • Micro-current
    • Russian
  • Line powered units for:
    • pain control
    • edema
    • strengthening
3:00 – 3:15 Break
3:15 – 5:15
  • Lab Activities
    • hands-on application of each modality by each course participant
    • Setup / parameter adjustment
    • Case Discussion / application
5:15 – 6:00 Dinner Break
6:00 – 7:00 Electrical Stimulation: Iontophoresis
7:00 – 8:00 Electric Stimulation Proficiency Test /Discussion
8:00 Adjourn

4-Day Agenda

 

Hours for the four day course are:
Day 1: 8am -6:30pm
Day 2: 8am -3:30pm
Day 3: 8am- 6pm
Day 4: 8am -3pm
Registration begins at 7:30 all days.

Modality Training Day 1
Thermal Agents

7:30 – 8:00 Registration
8:00 – 10:00
  • Overview of Physical Agents and Open Discussion on Current Trends of Physical Agent Usage:
    • Ultrasound
    • Electrical Stimulation
    • Diathermy
    • Iontophoresis
    • Laser
  • Ultrasound: Returning to the terminology:
    • What is Ultrasound
    • Principles of physics related to specific properties of ultrasound
    • Physiological, neurophysiological changes which occur during ultrasound application
  • Application of Ultrasound:
    • Terminology in setting treatment expectations
    • Attenuation
    • Beam Non-uniformity Ratio
    • Cavitation
    • Piezoelectric
    • Duty Cycle
    • Effective Radiating Area
    • Frequency
    • Spatial Average Intensity
    • Spatial Peak Intensity
10:00 – 10:30
  • Application of Ultrasound
    • Contraindications
    • Precautions
    • Safety rules
    • Client Education, Instruction
      • Risks
      • Benefits
      • Treatment Outcomes
  • Characteristics of the equipment (hands on instruction)
    • Operation
    • Adjustment
    • Care of the equipment
10:30 – 10:45 Break
10:45 – 12:00
  • Application of Ultrasound:
    • The response of normal and abnormal tissue to the application of ultrasound
      • Tissue Healing
      • Thermal vs. non-Thermal
      • Phono Phoresis
12:00 – 12:45 Lunch on your own
12:45 – 2:00
  • Review of the Ultrasound literature:
    • Trends in Ultrasound Use
    • Treatment suggestions according to the literature
2:00 – 3:00
  • Ultrasound Lab
    • Case based hands-on application lab
    • Methods of documenting treatment effectiveness
3:00 – 3:15 Break
Heat wave Physical Agent Modality: Diathermy
3:15 – 6:30
  • Diathermy:
    • Principles of physics related to specific properties of diathermy
    • Physiological and Neurophysiological changes with the application of diathermy
    • Tissue Response (Normal and Abnormal) to diathermy application
    • Characteristics of the equipment, operation, adjustment and care of the equipment
    • Literature Review
    • Indications, Contraindications
    • Guidelines for educating clients
      • Treatment outcomes
      • Risks
      • Benefits
6:30 Adjourn

Modality Training Day 2
Heat wave Physical Agent Modality
Diathermy

7:30 – 8:00 Registration
8:00 – 8:45
  • Diathermy
    • Case Based Hands-on Lab
    • Methods of documenting effectiveness
Light Wave Physical Agent: Laser
8:45 – 10:15
  • Laser and Light Therapy
    • Principles of physics related to specific properties of light therapy
    • Physiological and neurophysiological changes with the application of light therapy
    • Laser, LED, SLD
    • Review of the literature
10:15 – 10:30 Break
10:30 – 11:00
  • Laser and Light Therapy
    • Indications
    • Contraindications
    • Safety Rules
    • Client Education
      • Treatment outcomes
      • Risks
      • Benefits
11:00 – 12:00
  • Laser and Light Therapy
    • Characteristics of the equipment
      • Operation
      • Adjustment
      • Care of the equipment
12:00 – 12:45 Lunch on your own
12:45 – 1:45
  • Laser and Light Therapy
    • Case Based hands-on lab
    • Methods of documentation
1:45 – 2:45
  • Electrical Stimulation
    • Introduction to Electrical Stimulation Treatment
      • Principles of physics related to the properties of electricity
      • Electrophysiological changes as a result of electrical stimulation application
      • Tissue response (normal and abnormal)
    • Breaking down the terms and parameters
      • Motor Point
      • Overload Principle
      • Alternating Current
      • Continuous Current
      • Direct Current
      • Pulse Duration
      • Ramp
      • Frequency
      • Modulation
      • Amplitude
2:45 – 3:00 Break
3:00 – 3:30
  • Guidelines for educating clients regarding treatment outcomes during use of:
    • TENS
    • FES
    • Line Unit
      • Premodulated Current
      • High Volt
      • Russian
      • Interferential
3:30 Adjourn

Modality Training Day 3
Electrical Stimulation

7:30 – 8:00 Registration
8:00 – 10:15
  • Contraindications, Precautions, Safety rules related to the application of electrical stimulation
  • Methods of Pain Control
    • Gate Control Theory
    • Endogenous Opiate Theory
  • How the parameters manipulate the Electrical Stimulation Unit to obtain the desired treatment effects (hands-on)
  • Characteristics of the equipment
    • Operation
    • Adjustment
    • Care
      • TENS
        • Pain Control
        • Sensory
        • Acupuncture-like
        • Burst
      • FES
        • Strengthening
        • Orthotic Device
10:15 – 10:30 Break
10:30 – 12:00
  • Breaking down the line powered unit (hands-on):
  • Guidelines for educating clients about the process, outcome risks and benefits during application of electrical stimulation for:
    • Pain Control
      • High Volt
      • Interferential
    • Edema Control
      • Acute
      • Chronic
12:00 – 12:45 Lunch on your own
12:45 – 2:00
  • Breaking down the line powered unit (hands-on):
    • Wound Healing
    • Muscle Re-ed / Strengthening
      • Overload Principle
      • Fast Twitch Principle
2:00 – 3:00
  • Case Based Hands-on Lab
    • TENS
    • FES
3:00 – 3:15 Break
3:15 – 4:15
  • Case Based Hands-on Lab (cont)
    • Line Powered Units
      • Pain Control
      • Edema Control
      • Muscle Contraction
      • Wound Healing
4:15 – 6:00
  • Electrical Stimulation:
    • Iontophoresis
      • Principles of physics related to specific properties of electrical stimulation
      • Electrophysiological changes
      • Tissue response
      • Indications, Contraindications, Safety rules
      • Client education
      • Treatment outcomes
      • Risks
      • Benefits
      • Characteristics of the equipment
      • Medication options
      • Literature Review
      • Post-course assessment
6:00 Adjourn

Modality Training Day 4
Electrical Stimulation

7:30 – 8:00 Registration
8:00 – 10:30
  • Anatomy Review to prepare for motor point application
    • Upper Extremity Anatomy
      • Origin, Insertion, Function, Motor Points
    • Applying Anatomy to Finding Motor Points (hands-on lab)
10:30 – 10:45 Break
10:45 – 12:00
  • Electrical Stimulation
    • Functional Strengthening of the Upper Extremity
    • Hands-on Lab
      • FES
12:00 – 12:45 Lunch on your own
12:45 – 2:00
  • Electrical Stimulation
    • Hands-on Lab
      • Functional Strengthening of the upper extremity
        • Russian Stimulation
2:00 – 2:15 Break
2:15 – 3:00
  • Electrical Stimulation
    • Literature Review
    • Case Discussions
      • FES
      • Russian
      • High Volt
      • Premodulated
      • Interferential
3:00 Adjourn

Instructors:

Paul Higgins, DPT, ATC, CSCS

is an Assistant Professor in the Department of Rehabilitation Sciences at the University of Hartford. He earned his Master of Physical Therapy from American International College in 1999 and Transitional-DPT from Simmons College in 2006. He began teaching at the University of Hartford as an Adjunct Professor in 2003,was hired full time in 2009, and currently teaches Physical Agents, Anatomy and Orthopedic Pathology. Clinically, he is working in outpatient orthopedics and is co-owner of University Physical Therapy, LLC in West Hartford, CT. His research interests include physical agents and athletic performance.

Classes taught by Paul Higgins: