Objectives
Shortwave Diathermy
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Michael Banes
Deep Bhavsar
Ryan Machuca
ATPE 414
11/6/05
http://www.rehaboutlet.com/images/me300.jpg
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To learn what shortwave diathermy is.
Learn the physiological effects of shortwave
diathermy.
Learn how to use shortwave diathermy in a clinical
setting.
To be able to differentiate between treatment
techniques for continuous shortwave and pulsed
shortwave diathermy.
Learn setup and treatment guidelines for shortwave
diathermy.
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http://www.btlnet.com/imgen/shortwave.jpg
Indications and Contraindications
Pro’
Pro’s and Con’
Con’s
What is Shortwave Diathermy?
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Shortwave diathermy (SWD) is the application
of of highhigh-frequency electromagnetic energy that
is primarily used to generate heat in body tissues.
1,2
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The body is placed within an electrical field and
becomes part of an alternating current that is
generated from the SWD unit. 3
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This form of electrotherapy can be applied in
either a continuous (CSWD) mode or a pulsed
(PSWD) setting. 5
http://www.hms.harvard.edu/hmi/images/diathermy.jpg
•http://www.fbe.org.au/Clin/Basic
Equipment/EquipmentPictures/Di
athermy.jpg
What is Shortwave Diathermy?
Physiological Responses
(continued)
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Depending on the form of SWD you can elicit an
thermal treatment or a nonnon-thermal treatment. 2
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Heat is generated by the resistance of the passage of
energy through tissues. NonNon-thermal effects are elicited
through repolorization of damaged cells and the
correction of their dysfunction. 2,3
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The depth of penetration of SWD is equal to or greater
than ultrasound and greater than any infrared
modalities. 2
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The main effects of SWD are
to increase deep tissue
temperature, provide
vasodilation, and increase the
amount of blood flow to the
affected area 10
Electrical currents usually
penetrate 3cm deep
SWD is best modality to use
if goal is to increase
temperature 8
1
Clinical Applications
Clinical Applications
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SWD is commonly used in treating
musculoskeletal injuries such as strains,
tendonitis, tenosynovitis, bursitis,
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(continued)
CSWD thermal effects
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ligament sprains, and osteoarthritis. 2
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Local relaxation of
muscles
Decrease pain and muscle
spasm
Improve joint ROM 9
Increase elasticity of
collagen fibers
Increase circulation 2
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Theorized to speed repair in
slowslow-toto-heal wounds,
including nonunion fractures
and tendinopathy.3
Reduce swelling and
inflammation
Increase the rate of collagen
deposition and organization.
Increase nerve growth and
repair. 2
http://www.dcproductsreview.com/alternative/magnatherm_ssp.jpg
http://www.bestbackdocs.com/images/Diathermy.jpg
Continuous Shortwave Diathermy
(CSWD)
PSWD nonnon-thermal effects
Continuous Shortwave Diathermy
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Capacitance techniquetechnique- creates a stronger electrical field rather than a
magnetic field.
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Induction techniquetechnique- creates a stronger magnetic field and a
lesser electrical field.
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The athlete is placed inin-between the electrodes and becomes part of
the circuit.
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Induction methods create a eddy currents, small circular
fields, within the tissues that cause heat generation.
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Thus, the tissues that provide the most resistance inhibit the
amount of heat transfer to the body. So areas of the body that have
have
lower amounts of body fat tend to receive better electrical
2
transmission.
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In this method the athlete is not part of the circuit but part
of a parallel circuit where the current will flow through the
tissues that provide the least amount of resistance.
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Capacitance uses air space plates and pad electrodes to administer
administer
treatment. 2
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Induction uses cable and drum electrodes to distribute
treatment. 2
Pulsed Shortwave Diathermy
(PSWD)
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Instead of a continuous current it is a interrupted
current.
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The current is sent out as a highhigh-frequency burst with
short pulse durations thus providing the nonnon-thermal
effect with little to no sensory nerves stimulated. 7
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Typically a drum electrode setup is used when
administered. 2,7
Indications
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Joint inflammation
„ Use with caution because the deep heating
can cause destruction of the collagen
fibers.
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Large areas that cannot be heated through
other methods because of the size of the area.
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Fibrositis
„ Inflammation of fibrous connective tissue
that surrounds the muscles and causes pain
and stiffness. 8
2
Contraindications
Indications
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Myositis
„ Inflammation of a voluntary muscle that is characterized
by pain, tenderness, and muscle spasm in the affected
area
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Subacute and chronic inflammation of deep tissue layers
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Osteoarthritis
„ chronic degeneration of the cartilage of the joints 8
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Ischemic areas
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Peripheral vascular disease.
Metal implants or jewelry.
Perspiration and moist dressings.
Tendency to hemorrhage (including menstruation)
Cancer
Fever
Sensory loss 8
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Increased metabolic rate causes more hypoxia.
Contraindications
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Cardiac Pacemakers
Pregnancy
Epiphyseal plates in children
Genitals
Eyes and face
Infection sites
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The abdomen with implanted IUD 8
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Pro’s and Con’s
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Pros
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There must NOT be any metal within the treatment area. This
will cause collection and concentration of energy from the
treatment.
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The clinician should remove all jewelry and watches.
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Cover the treatment area with a DRY terry cloth towel to absorb
sweat. Excess sweat can accumulate heat from the treatment
and lead to burns.
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Cons
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General Setup
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Deep heating (2(2-5cm)
Covers a large area
Longer lasting effects than
ultrasound
Increases tissue temperatures
over 7 degrees F. 8
Can burn skin if sweating or
touching the pads, plates,
coils, cables or drum
Many states require a
prescription
Cannot use over areas with
excess adipose tissue
Deep tissues burns are
possible
It is difficult to heat a
specific area 8
Costly (around $5,500)
Condenser Plate Setup
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Adjust the plates so that they are parallel to the
skin and 1 inch above the patient.
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This can be done by using a spacer. Make sure to
remove the spacer before treatment begins.
Consult the owner’
owner’s manual for preferred
distance between the plates. 8
Explain to the patient that the treatment will cause a mild
warming sensation. 8
3
Condenser Pad Setup
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Cover the area to be treated with 6 layers of towels.
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Place the pads on the towels.
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If being used on the same side of body, separate as far as
possible
If being used on opposite sides of the body, make sure the
patient does not lie on the pads
Secure the pads in place with sandbags 8
Cable Method Setup
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Place 6 layers of towels around the body part
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Wrap the cable around the body part. Make
sure to leave at least 1 inch between the coils
and that the leads are equal length.
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Secure the cable ends so they don’
don’t touch the
patient, the machine, or each other. 8
Coil Method Setup
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Form a coil of at least 3 circles covering the area
treated.
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Drum Method Setup
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The circles should be 1 inch apart and the inner most coil
should be insulated.
Position the drum
approximately 0.5 to 1
inch above the toweling.
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Insulate the skin with at least 6 layers of towels
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Place the coil on the patient and lightly secure with
sandbags
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Position the leads so they do not come in contact with
each other 8
Application of SWD
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Setup for all different methods should be properly done
prior to turning machine on and applying settings
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Turn the unit on
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Some units need to be tuned to allow for maximal
energy transfer
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The patient should not move until the unit is turned off
8
There is a direct
relationship between the
distance of the drum and
the intensity of energy
required for the
treatment. 8
•http://www.drpicard.com/pics/treat/diather
my.jpg
Application of SWD
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Increase intensity until the athlete feels mild warmth.
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Always return the intensity to 0 before making any
adjustment to placement or drying areas.
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Check in with the patient regularly
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Return the intensity to 0 before turning off the unit
following the treatment.
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Treatments should last 2020-30 minutes and repeated as needed
for 2 weeks. 8
4
QUIZ
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How far should the coils be spaced from each other?
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A. 1 in
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B. 1 cm
C. 2 in
D. 3 cm
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QUIZ
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A. Increase circulation
B. Decrease pain and muscle spasm
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C. Reduces edema and inflammation
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D. Increases joint ROM
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How long should treatments last?
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A. 1515-20 minutes per session for 2 weeks
B. 2525-35 minutes per session for 3 weeks
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C. 2020-30 minutes per session for 2 weeks
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D. 3030-40 minutes per session for 1 week
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Which of the following does not consist of the
thermal effects of Continuous Shortwave
Diathermy (CSWD)?
QUIZ
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Shortwave diathermy uses a…
a…
„ A. Low frequency
„ B. High pulse duration
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QUIZ
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C. High frequency
D. Low amplitude
Which is NOT a type of SWD method?
„ A. Coil method
„ B. Drum method
C. 4
D. 6
Which is a contraindication for SWD?
„ A. Myositis
„ B. Osteoarthritis
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C. Circuit method
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C. Ischemic areas
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D. Cable method
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D. Joint inflammation
QUIZ
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B. 3
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In the coil method, how many circles should cover the area
being treated?
„ A. 2
SWD increases the temperature by
A. 2 degrees F
„ B. 9 degrees C
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References
1. Prentice, William E. . Therapeutic Modalities For Sports Medicine and Athletic Training
Training. 5th ed. New York: McGraw Hill,
2003.
2. The American Heritage Stedman's Medical Dictionary.
Dictionary. 2002 ed. : Houghton Mifflin Company.
3. Denegar, Craig R. . Therapeutic Modalities for Athletic Injuries.
Injuries. Champaign: Human Kinetics, 2000.
4. Nora, Shields, Gormley John, and O'Hare Neil. "Short"Short-wave diathermy: current clinical and safety practices." Physiotherapy
Research International 7.4 (2002): 191191-202.
5. Y, Laufer, Ziberman R, and Porat R. "Effect of pulsed shortshort-wave diathermy on pain and knee function of subjects with
osteoarthritis of the knee: a placeboplacebo-controlled doubledouble-blind clinical trial." Clinical Rehabilitation 2005: 255255-263.
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C. 7 degrees C
6. Charles, Murray, and Gkt Sheila. "Effect of pulse repetition rate on the perception of thermal sensation with pulsed
shortwave diathermy." Physiotherapy Research International 2000: 7373-85.
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D. 9 degrees F
7. Prentice E., William. Therapeutic Modalities for Physical Therapists.
Therapists. 2nd ed. New York: McGraw Hill, 2002.
8. Starkey, Chad. Therapeutic Modalities.
Modalities. 2nd ed. Philadelphia: F.A. Davis Company, 1999.
9. Peres, E. Steven, Draper, O. David, Knight, L. Kenneth, Ricard,
Ricard, D. Mark. “PulsedPulsed-Shortwave Diathermy and Prolonged
LongLong-Duration Stretching Increase Dorsiflexion Range of Motion More Than
Than Identical Stretching Without Diathermy.”
Diathermy.”
Journal of Athletic Training 37(1) 2002. pgs 4343-50.
10. Goats GC. “Continuous shortshort-wave (radio(radio-frequency) diathermy.”
diathermy.” British Journal of Sports Medicine 23(2) 1989. pgs 123123-7.
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