Which of the following is a general contraindication for PAMs?

• A. CVS
• B. Cognition/communication, vascular function, and sensation
• C. Open wounds only
• D. Local skin irritation from tape

Answer: (A)

General contraindications for physical agent modalities come from risks that affect the whole body or major systems. Cardiovascular and cerebrovascular conditions are a broad warning because most PAMs can cause changes in heart rate, blood pressure, or tissue perfusion. Heating can increase cardiac workload and circulation; electrical stimulation can influence heart rhythm; cooling and other modalities can alter vascular tone. In people with cardiovascular or cerebrovascular disease, these systemic effects can provoke symptoms, destabilize the condition, or create dangerous situations, so PAMs are generally avoided unless a clinician determines it’s safe.

Open wounds, local skin irritation, and safety concerns related to cognition, communication, or sensation are important considerations but are more modality- or site-specific. They don’t automatically preclude all PAMs across the board, whereas cardiovascular/cerebrovascular issues represent a broad, systemic contraindication.