Electrotherapy

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Electromagnetic
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Shortwave Diathermy (S.W.D.) – Microwave
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Diathermy (M.W.D.)
2015/2016 A.D.

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Objectives:
At the end of this lecture the student should be able to:

1. Define shortwave diathermy.

2. Explain physics of SWD.
3. Discuss the biophysical effect of the SWD.
4. Explain the therapeutic effects of SWD.
5. Describe different electrodes of SWD.
6. List indications and contra-indications of SWD.
7. Describe pulsed shortwave diathermy.
8. Define Microwave diathermy.
9. Discuss the production of MWD.
10. Describe directors of MWD.
11. Explain biophysical and biochemical effects of MWD.
12. List therapeutic effects of MWD.
13. List indications and contra-indications of MWD.

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 Shortwave Diathermy (S.W.D.)

Definition:
1. Shortwave diathermy (SWD) is one of the electromagnetic waves that is used in Physical
Therapy to produce LOCAL DEEP HEATING of the tissues by converting high-
frequency electromagnetic waves into heat.
2. The term Diathermy is formed of;
a. The prefix Dia-: which means through.
b. The suffix –thermy: which means heating.

3. Shortwave diathermy equipment used in Physical therapy uses the exclusive frequency
27.12 MHz and wavelength of 11 m to avoid its interference with radio waves used for
communication. This specific frequency band is also cheaper and easier in production.

Generation of SWD:
1. Electrostatic forces are the force acting between static electric charges.
a. They result in an attraction force between opposite charges and repulsion force
between same charges i.e., negative and positive charges attract, while two positive
charges repel.
b. The area between these charges is called the electric field. (Figure: 6.01)

2. When electrons of conductor are placed in an electric field, they will move to the positive
charge and produces an electric current.
3. This electric current will produce a magnetic field at right angle to the conductor.
(Figure: 6.02)
4. If the electric current is accelerated, it will produce the electromagnetic field.
5. If the electric current is oscillated, it will produce an electromagnetic radiation (S.W.D.)
with a frequency similar to the frequency of current oscillation.
6. This Shortwave Diathermy (S.W.D.) radiation will be converted inside the tissue into
high-frequency oscillating electric current, which will produce friction between ions and
molecules and then heat production.

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 Fig. 6.01: Electrostatic field.

Fig. 6.02: Electromagnetic field.

Interaction of S.W.D. with tissue molecules:

1. Interaction with free ions:
a. When free ions in the tissues are subjected to the oscillating electromagnetic field of
S.W.D., they will oscillate in their place with high frequency and minimal range of
movement.
b. This will result in collision and friction of these ions with the surrounding
molecules which in turn produces heat. (Figure: 6.03)
c. Friction produced by ion vibration produces maximal heating in the tissue.

2. Interaction with dipolar molecules:

a. The dipolar molecules as water are neutral electrically but carry opposite charges at
the ends of their molecules.
b. When they are subjected to the oscillating electromagnetic field of S.W.D., they will
rotate so that the negative charge moves toward the positive pole and vice versa.

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 c. With the high oscillation of S.W.D filed, the dipolar molecules will move in a
rotatory manner around themselves to a fro.
d. This rotatory movement will produce friction with the surrounding molecules,
which result in heat production in the tissues. (Figure: 6.04)
e. Friction produced by dipolar molecules produces moderate heat in the tissue.

3. Interaction with non-polar molecules:

a. Non-polar molecules as fat are minimally affected by electromagnetic field of
S.W.D.
b. The electromagnetic field of S.W.D. will cause electrons in the outer energy orbit of
these molecules to collect on one side, which produce minimal friction with
surrounding molecules and minimal heat production. (Figure: 6.05)

Fig. 6.03: Ion vibration in response to electromagnetic Fig. 6.04: Dipole rotation in response to electromagnetic
wave application. wave application.

Fig. 6.05: Response of non-polar molecules to Fig. 6.06: Eddy current generated with electromagnetic
electromagnetic wave application. (inductive techniques)

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Shortwave apparatus:
1. Shortwave diathermy apparatus consist of: (Figure: 6.07)
a. High frequency electric generator (oscillator circuit) producing high frequency
oscillating current with frequency of 27.12 MHz.
b. Resonant circuit (also called patient circuit) is composed of;
i. Inductance.
ii. Capacitance.
iii. Shortwave electrodes.
iv. Patient's tissue.

Fig. 6.07: Shortwave diathermy generator.

Shortwave electrodes:
Six main types of electrodes are commonly available in two groups:

1. Capacitive electrodes:
a. They produce electrostatic fields, i.e., stronger electric field than magnetic field.
b. Require two electrodes in the form of flat plates.
c. The produced field runs in linear form and the electron movements are also linear.
d. Capacitive electrodes generate more heat in subcutaneous fat layers and are best
used with body parts that have low subcutaneous fat content, e.g., hands, wrists,
feet and ankles. (Figure: 6.08)

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 e. They are two types;
i. Space plates:
 They are made of a two rigid metal plate electrodes encased in a
Perspex or plastic cover.
 They have different sizes ranging from 7.5 to 17.5 cm2.
 The metal plates can be moved around 3 cm within the coverings to
adjust its distance from the skin.
 The treated area is placed between the two space plates.

ii. Flexible pads:

 They are made of flexible metal plates covered with thick rubber
coverings.
 The treated part is placed between the two pads.
 Electrodes are separated from the skin by layers of towels. (Figure: 6.09)

2. Inductive electrodes:
a. They produce electromagnetic fields i.e., stronger magnetic field than electric field.
b. The produced fields and electron movements are in the form of semi-circular
currents called eddy currents. (Figure: 6.06)
c. All inductive electrodes are made of a wrapped coil.
d. Inductive electrodes produce maximum heating in water-containing tissues.

e. They are four types;

i. Coil: or cable electrode.
 It consists of a wire that is covered with rubber with plugs on both
ends.
 It can be applied as a pancake coil (Helix) or wrapped around the limb.
(Figure: 6.10)

ii. The monode: is made of flat rigid coil encased in Perspex or plastic cover.
(Figure: 6.11)

iii. The minode: is made of conical rigid coil encased in Perspex or plastic cover.

iv. The diplode: or Drum electrode.

 It consists of a central part and two wings. Each one of them is
considered a monode. (Figure: 6.12)

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Fig. 6.08: Space plates.

Fig. 6.09: Flexible pads.

Fig. 6.10: Coil electrode.

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 Fig. 6.11: Monode. Fig. 6.12: Diplode or drum electrode.

Physiological and Therapeutic Effects of S.W.D:

N.B.: S.W.D. is doubted to be CARCINOGENIC, so its application should be restricted to
limited cases.

1. Thermal effects of SWD:

The main physiological effect of SWD is the production of DEEP TISSUE HEATING.
S.W.D can heat DEEP muscles and tissues, which produce the following effects;

a. Improve tissue circulation, which;

i. Reduce inflammation.
ii. Reduce edema.
iii. Accelerate wound healing.
iv. Decrease infection.

b. Increase collagen tissue extensibility which increases joint ROM.

c. Reduce muscle spasm.
d. Relieves pain.

2. Non-thermal effects of SWD:

a. SWD increases microvascular circulation, which increases local tissue
oxygenation, nutrient availability and phagocytosis.
b. SWD affect ion binding to the cell membrane which activates;
i. Growth factor in fibroblasts.
ii. ATP and protein synthesis.
iii. Cell growth and division.
iv. Macrophages.
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Indications of SWD:
1. SWD is a heating modality that produces the same effects of other heating modalities but
concentrate heat on DEEP tissues.
2. It is used mainly in cases affecting deep tissues.
a. Musculoskeletal disorders: e.g., Osteomyelitis, osteoarthritis, tendonitis, bursitis,
and tenosynovitis.
b. Sport injuries: e.g., strain, sprain, capsular lesion, and contusions.
c. Pulmonary disorders: e.g.,
i. Bronchial asthma.
ii. Bronchitis.
d. ENT disorders: e.g., Sinusitis.
e. Genitourinary disorders: e.g.,
i. Fallopian tube adhesions.
ii. Endometritis,
f. Oral disorders: e.g.,
i. Gingivitis,
ii. Oral cyst.

Contraindications of SWD:
1. Unreliable patients.
2. Loss of sensation and analgesic drugs.
3. Patient receiving deep X-ray therapy.
4. Ischemia and poor circulation.
5. Neoplasm.
6. Pregnancy.
7. Metal implants.
8. Acute inflammations, infections and injuries.
9. Over the eyes and contact lenses.
10. Over the testes region.
11. Over growing epiphysis.
12. Pacemakers and severe cardiac and blood pressure abnormality conditions.
13. Open wound and burns.
14. Moderate and excessive edema.
15. Tendency of hemorrhage; during menstruation, peptic ulcer and varicose veins.
16. Severe cardiac condition and blood pressure abnormalities.

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 Pulsed Shortwave Diathermy (P.S.W.D)
1. Pulsed shortwave diathermy is the application of shortwave diathermy in an interrupted
form with constant intervals.
2. The waves are applied in bursts with;
a. Frequency rate of 15 - 200 bursts/second.
b. Burst duration of 0.4 msec.
3. The main advantage of pulsed S.W.D. is that a very high intensity can be applied with
less thermal effect, because heat generated during the on-time will be dissipated during
the longer off-time. (Figure: 6.13)

Fig. 6.13: Pulsations of the pulsed SWD.

Physiological Effects of (PSWD):

It has the same physiological effects and actions of the continuous SWD, but with less
thermal effect that allows application with acute cases.

Indications: Contraindications:
Same as non-pulsed SWD plus: Same contra-indications as non-
pulsed SWD.
1. Acute inflammation, infection and
injuries.

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 Microwave Diathermy (M.W.D.)

Definition:
1. Microwave diathermy (M.W.D) is a type of electromagnetic radiations which produce
DEEP TISSUE HEATING.
2. Most of the microwave generators used in Physical Therapy uses a wavelength of 122.5
mm and a frequency of 2450 MHz.
3. Some microwave machines (in P.T.) uses a wavelength of 327 mm (915 MHz) OR 690 mm
(433.9 MHz) which produces deeper penetration.

Microwave apparatus and production:

The microwave generator has three main components; (Figure: 6.14)

1. Multi-cavity magnetron valve: produces a high frequency alternating current.

2. Coaxial cable: transmit the high frequency alternating current to the antenna.

3. Antenna:
a. The antenna is made of piece of coiled wire that converts the high frequency electric
current into electromagnetic field.
b. The antenna is placed inside the M.W.D director.

Fig. 6.14: Production of MWD.

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Directors used in Microwave applications
There are different shapes of directors used in microwave applications; (Figure: 6.15)

1. Circular directors:
a. The heating pattern in circular directors is more intense at the outer portion of the
treated area than the center.
b. Circular directors are available in two sizes;
i. Large Circular Director: the effective diameter is around 200 mm. The power
output range is up to 250 watts.
ii. Small circular director: the effective diameter is around 100 mm. The power
output is up to 25 watts.

2. Longitudinal directors:
a. The heating pattern in longitudinal directors is more concentrated in the center of
the treated area than in the outer part.
b. The power output is up to 250 watts.
c. The diameter of the longitudinal director is 500 mm.

Fig. 6.15: Directors of MWD; a) large circular, b) small

circular and c) Longitudinal director.

Interactions of M.W.D.:
1. Penetration and Absorption:
a. M.W.D. energy absorption: most of the energy is absorbed in;
i. Tissue containing high water and ion content, e.g., skin and muscles.
ii. Superficial layers, e.g., skin and muscles.
b. M.W.D. has superficial penetration as compared to S.W.D., so, it is better used for
superficial tissues and for small areas.
c. The effective penetration of the 2450 MHz is approximately 3 cm.
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Physiological and Therapeutic Effects of Microwave Diathermy:
Microwave produces its therapeutic effects through production of DEEP TISSUE
HEATING which produces the same physiological and therapeutic effects of S.W.D.;

1. Increased blood flow and skin vasodilatation.

2. Pain relief.
3. Reduce muscle spasm.
4. Increase collagen tissue extensibility which increases ROM.
5. Reduce inflammation and edema.
6. Promote healing.
7. Reduce infection.

Indications of MWD
1. Same as S.W.D but used for more superficial and small areas.

Contra-indications:
1. Same as S.W.D plus:
2. Over wet dressings and adhesive tapes.

References:
1. Cameron MH.: Physical Agent in Rehabilitation from Research to Practice, 2nd Ed.
Saunders, 1999; Pp: 388-403.
2. Prentice WE, Quillen WS, Underwood F.: Therapeutic Modalities for Physical
Therapists, 2nd Ed. New York, The McGraw-Hill Companies, 2002; Pp: 171-192.
3. Robertson V, Ward A, Low J and Reed A.: Electrotherapy Explained, 4th Ed. Edinburgh,
Butterworth-Heinmann Companies, 2006; Pp: 385-424, 441-457.

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