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Nebraska PAMs Testing Service NPAMTS Test Objectives

1.  Cryotherapy  The occupational therapy practitioner should be able to demonstrate clinical knowledge of this subject by being able to:
1.a.  list the biophysical and biophysiological changes which occur with Cryotherapy.
1.b.  identify the indications, contraindications and precautions for the application of cold agents.
1.c.  demonstrate the clinical reasoning involved in the application of cold agents.
1.d.  identify commonly used types of cold agents.
1.e.  describe the application procedures for each cold modality presented in this module.

2.  Superficial Heat Agents  The occupational therapy practitioner should be able to demonstrate clinical knowledge of this subject by being able to:
2.a.  define the term superficial thermal agent.
2.b.  differentiate between the two commonly used methods of heat transfer:  conduction and convection.
2.c.  discuss the four biophysical effects of heat.
2.d.  describe the physiologic response to tissue secondary to temperature elevation.
2.e.  differentiate between mild, moderate and vigorous dosages of heat.
2.f.    list indications, precautions, and contraindications that should be considered when using superficial thermal agents.
2.g. describe the proper clinical applications for hot packs, paraffin bath, Fluidotherapy, whirlpool, and contrast bath.

3.  Therapeutic Ultrasound and Phonophoresis  The occupational therapist should be able to demonstrate clinical knowledge of this subject by being able to:
3.a.  discuss the theory and rationale for the application of therapeutic ultrasound and phonophoresis.
3.b.  outline and differentiate between the parameters for therapeutic ultrasound.
3.c.  outline current research trends in the utilization of ultrasound and phonophoresis.
3.d.  demonstrate clinical decision making in the determination of the appropriate treatment parameters for ultrasound and phonophoresis.
3.e.  discuss the clinical procedures for the application of ultrasound and phonophoresis.
3.f. present guidelines for the safe use of ultrasound and phonophoresis stating contraindications and precautions for treatment.

4.  Principles of Electrotherapy  The occupational therapist should be able to demonstrate clinical knowledge of this subject by being able to:
4.a.  identify the relationship between technical terminology and sensory responses.
4.b.  discuss the available parameters of electrical stimulation devices\describe the principles and concepts of electricity.
4.c.  identify the physiological effects of electrical stimulation.

5.  Transcutaneous Electrical Nerve Stimulation (TENS)    The occupational therapist should be able to demonstrate clinical knowledge of this subject by being able to:
5.a.  define the therapeutic goals of electrical therapy.
5.b.  identify the physiological events associated with electrical stimulation.
5.c.  define the distinguishing characteristic and indications and contraindications of electrical stimulation.
5.d. distinguish the physiological effects of various parameters of electrical stimulation (voltage, type, dosage, duty cycle, etc.).
5.e.  discuss the therapeutic relationship of electrotherapy with other therapeutic procedures.

6.  Neuromuscular electrical stimulation (NMES)    The occupational therapist should be able to demonstrate clinical knowledge of this subject by being able to:
6.a. describe the clinical application of electrical stimulation in rehabilitation.
6.b. outline and discuss the clinical reasoning process used to determine selection of NMES and appropriate parameters.
6.c. describe the parameters of therapeutic electrical currents.
6.d. identify the biophysiological responses to electrical currents.
6.e. discuss the indications and contraindications for NMES use.
6.f.  identify appropriate electrode placement for treatment protocols.

7.  Iontophoresis    The occupational therapist should be able to demonstrate clinical knowledge of this subject by being able to:
7.a. describe the clinical applications for iontophoresis.
7.b. discuss the biophysiology and mechanism related to transdermal delivery of medication.
7.c. identify common medications used in iontophoresis and their pharmacology.
7.d. outline clinical decision making regarding iontophoresis, indications and precautions .

8.  Pharmacology    The occupational therapist should be able to demonstrate clinical knowledge of this subject by being able to:
8.a. discuss the following processes in pharmacokinetics: absorption, distribution, and metabolism.
8.b. explain the processes of pharmacodynamics as it pertains to routine drugs used in phonophoresis and iontophoresis.
8.c. discuss the effects of physical agents, exercise, and manual techniques on pharmacokinetics.
8.d.  discuss the aging process as it relates to pharmacokinetics.

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