1. Methods of Heat Production

2.  Reflex heating  Shoulder (proximal)  vasodilation  Hand (distal)  vasoconstriction followed by vasodilation

3. Methods of Application 1.Wax 2.Heated pads & packs 3.Hydrotherapy 4.Heated air 5.Fluidotherapy 6.Contrast bath

4. Wax  Restricted to extremities  Melted to allow subject to dip in  Melting point 54°C (S.H. of wax<water)  Mineral oil added  Thermostatically controlled bath (42- 50°C)

5. Wax  First layer as insulator to prevent heat loss  Solidification of wax  small imparted to tissue  Wax is a well insulated, low temperature method of tissue heating  Higher temperature for upper extremities  Lower temperature for lower extremities  Before application inspect the area for contraindications, wash & dry

6. Methods of Wax Application 1.Dip and rap method (used for extremities)  Part immersed for a second then withdrawn and allowed to cool for 2-3 seconds then re-immersed, & this is repeated 6 – 12 times  Coating 2 – 3 mm  Put the part in towel  Elevate the limb  Apply for 15 minutes

7. Methods of Wax Application 2.Dip and leave method  Build a layer of wax  Leave the part in wax bath for 15 – 20 minutes  Increases the temperature more than other method

8. Other Methods of Wax Application  A brush can be used  Bandage soaked in wax and wrapped  Ladling Wax keeps the skin moist and soft

9. Contraindications  Open wounds  Allergy  Inflammation  Pieces of dirt  might cause infection  Skin condition like dermatitis

10. Advantages  Maintain good contact with the contoured area  Easy to use  Inexpensive  Body part can be elevated if using dip & wrap  Oil lubricates and conditions the skin  Can be used at home

11. Disadvantages  Time consuming to apply  Can not be used over open wounds  Risk of cross-contamination if paraffin is re-used

12. Heated Pads & Packs  Provides heat for small areas Hydrocollated pads  Various sized for different areas of the body  Consist of silicate gel  Placed in special tank of water (hydrocollater)

13. Heated Pads & Packs  Pack supported on racks in the tank  Temperature of water 70 - 75°C  Wrapped with toweling (Terry towel)  Applied for 20 minutes (15 – 20 minutes)  If the pack wasn’t in the tank before  put in the tank for 2 hours before using  Between uses  30 minutes in the tank

14. Heated Pads & Packs  Other types:  Kenny pack  Mud pack  Electrical heated pack (small  blanket size)

15. Advantages of Heated Pads & Packs  Easy to use  Inexpensive material  Short use of clinician’s time  Low level of skill needed for application  Can be used to cover moderate to large areas  Safe  Can be used at home

16. Disadvantages of Heated Pads & Packs  Must be moved during treatment time  May not be able to maintain good contact with small areas  Active motion not practical during treatment  Moderately expensive equipment

17. Hydrotherapy  Use warm water for swimming and exercising  more therapeutic effect  Whirlpool path of various sizes  Small to accommodate one limb  Large to allow patient to sit in it  Turbulence produced by electric pump or compressed air which mixes air in water into a jet steam

18. Hydrotherapy  Causes analgesic effect  Temperature 36 - 41°C  Anti-bacterial agent added to water (e.g. sodium hydrochloride 1-120 dilution)  Followed by exercise with elevation  Applied for 20 minutes  If applied for long time  cause wrinkling of the skin

19. Heated Air  Mixture of air and vapor as hot air baths  Small hot air cabinets  Small hand held fan heaters (open wounds as bed sores)  Cabinet for whole body  Temperature of cabinet 70°C

20. Advantages  Possible to move treated part during treatment  Lack of contact with wet materials

21. Fluidotherapy  Form of dry heating  Produce fluid like mixture into which distal part of limb immersed in the box  Cellulose particles made of corn cobs  Open wounds must be covered to prevent powder covering  Temperature 38 – 45 °C  Application for 20 minutes