A Modality is applied to a patient to assist in rehab, for example, hot packs, cold packs, fluidotherapy, etc. There are many therapist who use modalities, some do not believe in having them in rehab and others use them way to much in rehab.
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The question is, are modalities really helpful? The answer is yes, think about it, you have some stiffness in your quads, which is leading to limit of your range of motion. Add a superficial heat, a hot pack, to get your muscle to relax decreasing pain and stiffness, increasing circulation, and your range of motion. Same thing with cold packs, you are experiencing some pain and edema (swelling), prop up your leg and put a cold pack on to reduce pain and edema, but make sure the edema is from inflammation not circulation, cold can reduce circulation and you want to keep that.
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This picture almost sums up heat and cold, which I used asa quick reference when studying for a modality exam.
There are different modalities for different reasons, hot and cold packs are the most used. I work in an outpatient clinic and we use hot packs and cold packs for ALMOST patient we have. Given they are very helpful, there are some contraindications for every modality. For cold packs it could be cold tolerance or Reynaud's disease (a primary or idiopathic form of paroxysmal digital cyanosis that results from some other regional or systemic disorder which causes pain when subject is exposed to cold), etc. Hot packs contraindications are malignancy (increased blood flow will promote metastasis), thrombophlebitis, acute inflammation, etc. So when choosing a modality, you have to know your patient, do they have or have had a tumor? Then you would not use a hot pack because of malignancy.
One of my favorite modalities is the fluidotherapy machine, it uses finely divided solid particles (like corn husks) that acquire the characteristics of fluid, and is suspended in a heated air steam. It helps patients with arthritis for pain relief and increases circulation. I used one of these in my class for Physical Agents and it felt like I was grabbing warm soft sand, it is a really relaxing modality, but there has been research that other modalities provide the same effects for arthritis and other symptoms for cheaper, and better outcomes. So you do not see fluidotherapy around much anymore.
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There are other kinds of modalities like ultrasound, laser and lights, and diathermy, these are for more deep heat and also provide non-thermal effects. As a SPTA, I do not believe in using modalities as the main interventions, but I do believe they are helpful, not because I read about it, but because I have seen it. I have seen patients come into my work with radiating pain, the therapist uses a modality to relieve their pain and they continue with their interventions (like their exercises) with a less pain after that modality. Modalities are helpful in the clinic but it is still the knowledge the PT has to have in order to assign the patient that modality and the rest of the intervention to get the patient to returning back to function.
Thank you for reading! I hope this gives a better understanding what modalities are.
