PHYSICAL AGENT MODALITIES (PAM) EXAM 3 PART 9 – FLUIDS STUDY GUIDE, PRACTICE
QUESTIONS & ANSWERS 2026/2027
Physical Agent Modalities (PAMs) - ANS ✔✔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 or inflammation.
PAMs are
used in preparation for or concurrently with purposeful and occupation-based activities
(Bracciano, 2008).
PAM's - ANS ✔✔-Thermal agents: Cold and hot pack, paraffin.
-Electrotherapeutic agents: Biofeedback, Neuromuscular electrical stim, Functional electrical
stim, Galvanic (high voltage) stim, Iontophoresis, Phonophoresis, TENS
-Mechanical devices
NMES - ANS ✔✔he use of electrical current to the use of electrical current to
increase ROM, decrease edema and increase ROM, decrease edema and increase strength
FES - ANS ✔✔The use of NMES on innervated innervated ddmuscle to achieve functional or
purposeful to achieve functional or purposeful
movements or gain functional control. movements or gain functional control.
do not use FES - ANS ✔✔• with patients who have certain types of pacemakers
• over the carotid sinus area
• over the heart or transthoracically
, • over the mouth/throat area
• on open wounds or irritated skin
• over cancerous lesions
FES Contraindications - ANS ✔✔FES will not be effective on patients having significant
peripheral nerve injury or pathologies such as:
• problems in the cell body
• problems in the axon
• major damage to the myelin sheath
• problems at the synapses between the muscle & the nerve
• problems within the muscle
Superficial thermal agents - ANS ✔✔include but are not limited to hydrotherapy/whirlpool,
cryotherapy (cold
packs, ice), Fluidotherapy™, hot packs, paraffin, water, infrared, and other commercially
available
superficial heating and cooling technologies
factor that effect current flow (FES) - ANS ✔✔Impedence is opposition is opposition
to flow of an electric to flow of an electric
current current
• Muscle = 75% water
• Fat = 15% water
• Bone = 10% water
So, you want to place the electrode on the
"motor point motor point", over the muscle, where the fibers are most dense
• Electrode size
QUESTIONS & ANSWERS 2026/2027
Physical Agent Modalities (PAMs) - ANS ✔✔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 or inflammation.
PAMs are
used in preparation for or concurrently with purposeful and occupation-based activities
(Bracciano, 2008).
PAM's - ANS ✔✔-Thermal agents: Cold and hot pack, paraffin.
-Electrotherapeutic agents: Biofeedback, Neuromuscular electrical stim, Functional electrical
stim, Galvanic (high voltage) stim, Iontophoresis, Phonophoresis, TENS
-Mechanical devices
NMES - ANS ✔✔he use of electrical current to the use of electrical current to
increase ROM, decrease edema and increase ROM, decrease edema and increase strength
FES - ANS ✔✔The use of NMES on innervated innervated ddmuscle to achieve functional or
purposeful to achieve functional or purposeful
movements or gain functional control. movements or gain functional control.
do not use FES - ANS ✔✔• with patients who have certain types of pacemakers
• over the carotid sinus area
• over the heart or transthoracically
, • over the mouth/throat area
• on open wounds or irritated skin
• over cancerous lesions
FES Contraindications - ANS ✔✔FES will not be effective on patients having significant
peripheral nerve injury or pathologies such as:
• problems in the cell body
• problems in the axon
• major damage to the myelin sheath
• problems at the synapses between the muscle & the nerve
• problems within the muscle
Superficial thermal agents - ANS ✔✔include but are not limited to hydrotherapy/whirlpool,
cryotherapy (cold
packs, ice), Fluidotherapy™, hot packs, paraffin, water, infrared, and other commercially
available
superficial heating and cooling technologies
factor that effect current flow (FES) - ANS ✔✔Impedence is opposition is opposition
to flow of an electric to flow of an electric
current current
• Muscle = 75% water
• Fat = 15% water
• Bone = 10% water
So, you want to place the electrode on the
"motor point motor point", over the muscle, where the fibers are most dense
• Electrode size
