Shortwave Diathermy
Prof. Dr. Gehan MosaadAt the end of the lecture the
student should be able to
e Define short wave diathermy and know its
types
e Discuss the mechanism of heat production by
SWD
e Understand methods and techniques of SW
application
e Identify factors affecting field distribution
e Know the precautions of using SWDShortwave Diathermy
SWD is a means of producing therapeutic heat in
the tissues by the use of radio waves of high
frequency.
Shortwave radiation is within the radiofrequency
range( 3 kHz to 300 MHz and wavelengths of 1 m to
100 km).
SWD machine used by physiotherapy utilize the
frequency of 27.12 MHz and wavelength of 11 meter.
There are two types of SWD
~ Continuous shortwave
Pulsed shortwaveHeat Production by SWD
+ Any living tissue consists of three types
of molecules:
e Charged molecules
e Dipolar molecules
e Non polar molecules
+ All of three types will influence the
conductivity and hence the heating
produced by SWDHeat Production by SWD (cont)
Passing a current of sufficient intensity at a high
frequency increases the internal kinetic energy of
matter causes heating and increase temperature in
the material.
SWD produces heat through tissue by:
Vibration of charged molecules (ions and certain
proteins)
- Rotation of dipolar molecules (water and some
proteins)
- Distortion of non-polar molecules (fat cells)Molecular reaction to high frequency
alternating currentMethods of shortwave
application
e Capacitive method
By using:
v Air space plates
v Pad electrodes.
e Inductive method
By using:
vy Cables
vy Drums.Capacitive method
A high-frequency a alternating electric current
flows from one plate to the other through
the patient.
The patient is part of the electric
circuit connecting the two electrodes.
Area to be treated is placed between
electrodes and becomes part of external circuit.
As the current flows through the tissue,
it causes oscillation of charged particles
and thus increases tissue temperature.Capacitive method
1- Air Space Plates
e They are metal
plates encased ina
plastic housing.
e Metal plates can be
adjusted 3cm within
guard.Capacitive method
Air Space PlatesCapacitive method
2- Pad Electrodes
They are malleable
metal covered with a
thin layer of rubber
They must have
uniform contact
pressure on the body
Towels are used to
prevent burnsInductive method
e The tissues are placed in the electromagnetic field by
the use of an insulated cable or coil electrode which is
available in two forms cable and drum electrodes.
1- The cable electrodes
e They are bundles of plastic-coated wires
e The cable may be wrapped around the extremity or
coiled flat like a pancake and placed on the skin.
e When an alternating electric current flows through
these wires, eddy currents are induced inside the limb.
e Patient placed in a magnetic field NOT part of a circuitsherware
abery ie
The cable is wrapped The cable is coiled flat like
around a_pancake and placed on
eed BES i)Inductive method(cont.)
2- Drum electrodes
« Adrum applicator is made of a flat spiral coil inside a
plastic housing.
« The drum is placed directly over the area being
treated, and the flow of alternating electric current in
the coil produces a magnetic field, which in turn
induces eddy currents within the tissues.
+ Diathermy devices with drum applicators may have
one or two drums or a single drum that can be bent
to the area being treated.OMe cM lee i eMac tlice
tot ETaTe)Inductive method (cont.)
When high frequency alternating current (AC)
flows in the inductive coil produces magnetic
field perpendicular to the coil which in turn
produces eddy current inside the tissue.
These induced electric currents cause charged
particles in the tissue to oscillate that leads to an
elevation in tissue temperature
The amount of heat generated in the tissue is
affected by the strength of the magnetic field
that reaches the tissue and by the strength and
intensity of the induced eddy current.Inductive method (cont.)
The strength of magnetic field is affected by the
distance of tissue from the applicator according to
inverse square law.
The strength of the induced eddy currents is
determined by:
- strength of the magnetic field in the area
- electrical conductivity of the tissue in the area.
The electrical conductivity of tissue depends
primarily on
- tissue type
- frequency of the signal being applied.Inductive method (cont.)
e Metals and tissues with a high water and
electrolyte content, such as muscle or synovial
fluid, have high electrical conductivity, whereas
tissues with a low water content, such as fat,
bone, and collagen, have low electrical
conductivity.
e Thus, inductive coils can heat both deep and
superficial tissues, but they produce the most
heat in tissues with the highest electrical
conductivity+ The drum is placed directly
over the area being treated
+ May use more than one
drum depending on treatment
area
+ Toweling is important
The cable is arranged ina
pancake shape
+ Towel between skin and coil
+ Spacing between turns in coil
must be at least 3cm and
maintained by using rubber or
wooden spacer.Techniques of application of
SWD
|. Positioning of electrode in capacitive method
e Contraplanner technique:
It is used to treat structure on the two aspect of the body. Two
electrodes are placed on opposite sides of the part being
treated e.g. joint.
e Co-planner technique:
It is used to treat structure on one aspect of the body .Two
electrodes are placed on the same line together of the part
being treated e.g. back.Techniques of application of
SWD (cont.)
The distance between electrodes must be greater than
sum of skin electrode distance, other wise the line of
force passes between the electrodes rather than
through the tissue
e Cross fire technique
The position of electrodes is contra planner technique.
But, half of treatment time, the electrodes are placed
anterior and posterior to the treated area and the
second half of time, the electrodes are repositioned,
lateral and medial to the treated area, e.g. pelvis.Techniques of application of
SWD (cont.)
Il. Shape of electrode in inductive method.
In case of cable electrode
e wrapped around the extremity
e coiled flat like a pancake and placed on the
skinFactors affecting field distribution
Capacitive Electrodes
1- Spacing of electrode:
- Normal spacing
- Closely spaced
- Far spaced
- Unequal spacing
2- Size of electrode:
Uniform field
Superficial heating
Deep heating
Superficial heat under closer one
- Electrode is little larger than the part Uniform field
- Electrode is too bigger than the part Heat loss
- Electrode is too smaller than the part Superficial heat
- Electrode are of unequal size
under smaller one
Superficial heatFactors affecting field
distribution (cont.)
3- Position of electrode relative to the tissue
- Electrode parallel to skin surface
Uniform field
- The distance between electrodes less than the
combined skin electrode distances
Most of field passes through air space
- Electrode isn't parallel to skin surface
Superficial heat under closest part of electrodeFactors aifecting field distributionPrecautions
e Electronic or magnetic equipment in the field
The SWD device should be isolated from these devices.
Because the treatment field may interfere with such
equipments as computers. It is recommended that the
leads and applicators of diathermy devices be at least 3
m, and preferably 5 m, from other equipments.
Obesity
Diathermy should be used with caution in obese
patient because it may heat fat excessively, especially
capacitive plate.
Copper bearing intra-uterine contraceptive devices
Diathermy should be used with caution with patient
using copper-bearing intrauterine contraceptive device.When Should Diathermy
Be Used?
e If the skin or some underlying soft tissue
is tender and is unable to tolerate
pressure.
e When the treatment goal is to increase
tissue temperatures in a large area.
e In areas where subcutaneous fat is thick
and deep heating is required.Case study
Case 1
MS is a 50-year-old female. She has been diagnosed with
adhesive capsulitis of the right shoulder and has been
referred to physical therapy. She complains of shoulders
stiffness. The objective exam reveals restricted right
shoulder active and passive range of motion.
Case 2
AB is a 24-year-old male, football player who suffered from
left ankle inversion sprain approximately 48 hours ago.
He complains of moderate pain and swelling at the
lateral ankle.