Infrared Radiation Therapy PDF

Infra-Red Radiation Therapy Dr. Maha Ahmed Elsayed Lecturer of physical therapy El saleheya El gadida University  Students learning objectives 1. Define Infra-Red Radiation (IRR). 2. Identify the classification of Infra-red radiations. 3. Understand production of Infra-Red Radiation...

Infra-Red Radiation Therapy Dr. Maha Ahmed Elsayed Lecturer of physical therapy El saleheya El gadida University  Students learning objectives 1. Define Infra-Red Radiation (IRR). 2. Identify the classification of Infra-red radiations. 3. Understand production of Infra-Red Radiation. 4. Identify Sources of Infra-red radiations 5. Explain physiological effects of IRR 6. Identify indications and contraindications of IRR. 7. Identify hazards and potential dangers of IRR. 8. Identify advantages and disadvantages of IRR.  Definition  Infra-red rays are electromagnetic wave with wavelengths 760nm :1mm that lie between microwave and visible light in the electromagnetic spectrum. Classification of infrared radiations: Type Wavelength Penetration IRA (short IR) 760-1400 nm 5 mm reach to dermis IRB(long IR) 1400-3000 Up to 1 mm to nm epidermis IRC 3000-1mm not used in therapy  Production of infrared radiations:  Infrared radiations are produced because of molecular motion within heated materials.  An increase in temperature above absolute zero results in the vibration or rotation of molecules within the matter, which lead to the emission of infrared radiations.  Sources of infrared radiations:  Infrared sources can be either: 1. Natural (the sun) 2. Artificial.  Artificial sources are classified as: 1. Luminous I.R sources(generators):  Luminous lamps are produced by electrically heated filament made of tungsten in an evacuated glass bulb which contains an inert gas at a low pressure; part of the glass bulb is silvered to provide a reflector.  Power levels emitted range from 250-1500W.  Emission of luminous sources  luminous sources emit mainly: 70% short IR 24% long IR 5% visible light 1% UV rays  2. Non-Luminous I.R sources:  Produce IRR from non-glowing sources such as moist hot packs and non-luminous lamps.  Produced by electrically heated resistance wire coiled on a cylinder of insulating material such as porcelain.  The resistance wire serves as-the heater, and the cylinder becomes the radiation source.  2. Non-Luminous I.R sources:  Power levels emitted range from 250-1000W.  The elements of the non-luminous lamps take about 5: 10 minutes to heat up and emit their maximum intensity, so lamps must be switched on at an appropriate time before they are required.  2. Non-Luminous I.R sources:  It has been suggested that the non-luminous units apparently feel hotter than do the luminous at equal distances and power levels, due to the increased absorption of the longer wave lengths by the top layers of the skin.  Emission of non- luminous sources  Non-luminous sources emit mainly long IR radiation around 3000-4000 nm 10% short IR. Absorption and penetration of IRR:  IRR is strongly absorbed near the skin surface, and the heat is carried to the deeper tissues by conduction and by the circulating fluids.  Absorption of IRR and the maximal penetration of the rays depend on: 1. Frequency or wavelength of the rays. 2. Angle of incidence of the rays. 3. The intensity of the emitting source. 4. Thermal conductivity of the tissue. 5. Density of each tissue. 6. Distance from the source of infrared. 7. Patency of the circulation. 8. Source of IR (luminous or non-luminous). Physiological Effects of IRR: 1.Cutaneous vasodilatation 2.Increase metabolism 3.Pain control 4.Neurological effect 5.Effect on connective tissue 6.Sweating 7.Blood pressure 8.Pigmentation:  1. Cutaneous vasodilatation  The vasodilatation starts after a short latent period of 1 to 2 minutes and appears as an irregular patchy erythema.  This local erythema appears immediately after exposure to IRR and lasts 30 minutes after treatment has stopped.  1. Cutaneous vasodilatation  Heating with IRR leads to vasodilatation of the capillaries because of release of chemical mediator histamine like substance and axon reflex mechanism.  The heat regulating center in medulla also signals the capillaries to vasodilate when the temperature rises. Vasodilatation causes increase blood flow in the cutaneous circulation  2. Increase in metabolism  Increase temperature by IRR leads to increase metabolic activities within the superficial tissue due to direct effect of heat on chemical process in the cell.  Increase metabolic activities lead to improve cell function and improve tissue healing.  3. Pain control  The heat production by IRR leads to relief pain by: a. Stimulation of sensory nerves (A-Beta nerve fibers) lead to inhibition of pain at the level of the spinal cord. b. Decrease activity of muscle spindle leading to decrease muscle spasm and causing muscle relaxation. c. Removal of waste products as the result of improving circulation and increase venous return thus removing the source of pain stimulation  4. Neurological effect  IRR increase nerve conduction velocities. 5. Effect on connective tissue (increase tissue extensibility):  The heat effect of IR leads to increase the extensibility of connective tissue and therefore is used prior to exercise to increase range of motion (stretching and mobilization exercises).  N.B. Increasing tissue extensibility by heating through IRR will not decrease soft tissue shortening, so infrared must be used in conjunction with stretching and ROM exercises.  6. sweating:  There is increase activity of sweat glands by reflex stimulation from heat regulating system.  7. blood pressure:  If the heating is given to a large area of the body for a prolonged period, there will be fall in blood pressure.  8. Pigmentation:  Excessive prolonged application can cause destruction of erythrocytes, releasing pigments and cause brown discoloration.  Therapeutic Uses and indications of IRR: 1. Relief of pain:  Pain may be due to accumulation of waste product of metabolism in the tissue  So increased blood flow through the part by IR lead to removal of chemical mediators which causes irritation of nerve ending and lead to relief of pain. Sedative effect:  Mild heating increases skin temperature that led to state of analgesia by increase pain threshold. Counterirritant effect:  Strong heating stimulates the superficial sensory nerve fibers which blocking the transmission of pain. 2.Reduction of Muscle spasm:  Muscle relaxes when tissues are warm, and relief of pain facilitates relaxation.  So, IR can be used prior to other forms of physical therapy. 3. Acceleration of tissue healing:  IR accelerates tissue healing by increasing circulation and enzymatic activity.  A good blood supply to the tissue is essential for healing to take place.  3. Acceleration of tissue healing:  Increase blood supply brings more oxygen and nutrients to tissue and removes waste products.  Increasing the temperature of blood by IR increases the dissociation of oxygen from hemoglobin to tissue, making more oxygen available for the process of tissue repair.  4. Reduction of joint stiffness:  Increases extensibility of soft tissue that occurs with increasing its temperature.  It's preferable to perform stretching exercises immediately after application of IR.  5.Reduction of edema:  IR reduces chronic edema of the hand and foot, but with elevation during treatment.  Vessel’s dilation induced by heating will allow increased rates of fluid exchange and thus may help to increase the reabsorption of exudates. 6. Sub-acute and chronic inflammation of musculoskeletal system. 7. Prior to stretching-and mobilization exercises. 8. Some skin conditions as fungal infection.  Indications: 1. Relief of pain 2. Reduction of Muscle spasm 3. Acceleration of tissue healing 4. Reduction of joint stiffness 5. Reduction of edema 6. Sub-acute and chronic inflammation of musculoskeletal system. 7. Prior to stretching-and mobilization exercises. 8. Some skin conditions as fungal infection.  Contraindications to IRR 1.Impaired sensation:  patients with impaired sensation in the area to be treated will not be able to determine if excessive heating is occurring.  Large areas of scar tissue with impaired sensation will also be a contraindication.  Contraindications to IRR (cont.) 2. Acute injury or acute inflammation:  Increasing tissue temperature can increase edema and bleeding because of vasodilatation and increased blood flow.  This may aggravate the injury, increase pain and or delay recovery.  Contraindications to IRR (cont.) 3. Acute infection:  All acute infections are a contraindication to IR  The increase in temperature is likely to exacerbate the infective process.  Contraindications to IRR (cont.) 4. Impaired circulation (defective arterial blood supply):  When there’s a history of defective circulation from any circulatory disease (atherosclerosis, deep venous thrombosis), care must be taken not to administer heat over the area with impaired circulation.  The function of skin circulation is to dissipate heat, and if this heat regulating mechanism is defective, it would be quite easy to cause a burn.  Contraindications to IRR (cont.) 5. Metal  There should be no metal in the area that is irradiated.  Metal retains the heat and will cause a burn to the underlying tissue.  Deep metal implants are not a contraindication.  Contraindications to IRR (cont.) 6. Eyes  Radiations can cause cataracts.  This will occur if I.R.R is given over a long period.  It can also cause iritis.  Contraindications to IRR (cont.) 7.Topical creams and oils (recent use of ointment):  All topical creams and oils must be removed before giving I.R.R, or the creams and oils will cause burns. Because they make the skin hypersensitive.  Contraindications to IRR (cont.) 8. Blood pressure abnormalities:  I.R.R should not be given to large areas for a prolonged time, as the patient may be unable to tolerate the change in BP which may be produced.  Contraindications to IRR (cont.) 9. Sever cardiac conditions:  Heating a large area will cause an increase in cardiac output which may not be tolerated by patients with severe cardiac conditions.  Contraindications to IRR (cont.) 10.Unreliable patients:  Very young people: unreliable in reporting the heat intensity, there is a tendency to fall asleep, and they lack the normal C.V and respiratory reserves. 11. Skin tumors:  patients with skin tumors or melanoma must not receive I.R.R, as the tumor growth may be increased. Contraindications to IRR (cont.) 12. Very old people:  They generally have impairment of sensation and circulation, and in these patients’ large areas must not be irradiated. 13. The testes:  Temporary lowering of sperm count.  Contraindications to IRR (cont.) 14. Analgesic and narcotic drugs:  If the patient have had strong analgesic or narcotic drugs just prior to treatment  I.R.R must not be given as these drugs will raise the pain threshold and the patient will not be able to determine whether the IRR are of too great intensity.  Contraindications to IRR (cont.) 15.Deep X-Ray therapy:  For 3 months after therapy, patients must not be given I.R.R, as deep X-Ray therapy reduces sensory appreciation. 17. Open wound. 18. Danger of hemorrhage (hemophilia). 19. Over pregnant uterus  Hazards and Potential Dangers 1. Burns:  The main danger of IR treatment is a burn. Burns are always a potential risk if: a. Heat is too intense. b. The patient is not completely aware of the level of heating or, cannot communicate clearly. c. Patients move closer to the lamp. d. Patient falls to sleep 2. Eye Damage:  Occurs when the patient looks directly to the lamp causing dryness or irritation.  Hazards and Potential Dangers(cont.) 3. Dehydration:  Due to excess sweating caused by prolonged application over large area of the body. 4. Lowered blood pressure:  due to excess sweating and marked vasodilatation especially in elderly.  Hazards and Potential Dangers(cont.) 5. Fainting: Extensive radiation may cause falling in blood pressure that may cause fainting. 6. Electric shock: Can occur if some exposed part of the circuit is touched by the patient and thus regular checking of wires is necessary to avoid electric shock.  Advantages of IRR: 1. Does not require contact of the medium with the patient, which reduces the risk of infection and the possible discomfort of the weight of a hot pack. 2. The area being treated can be observed throughout the intervention. 3. It can be used to treat large areas.  Disadvantages of IRR: 1. Infrared radiation is not easily localized to a specific treatment area. 2. Treatment is only very superficial. 3. Equipment is often other unstable. 