Diathermy

PAMANTASAN NG LUNGSOD NG MAYNILA

COLLEGE OF PHYSICAL THERAPY
 Topic Outline
Introduction
Definition
Different electromagnetic phenomena
Different physiologic responses brought by diathermy
SWD vs MWD
Frequency, wavelength, & characteristics
Parts
Physiologic & therapeutic effects
Indications, CI, precautions, & risks
Related dangers
Pulsed SWD
Definition
"Through heat"
Application of shortwave or

microwave electromagnetic

energy to produce heat and

other physiological changes

within tissues
Can be delivered:
Continuously
Pulsed or bursts of radio frequency energy
Pulsed shortwave diathermy (PSWD)
Pulsed electromagnetic fields (PEMF)
Pulsed radio frequency energy

(PRFE)
Electromagnetic Phenomena
Electrostatics
Electric current with magnetic force - produces

eddy currents or circular currents

Electromagnetic radiation - only a byproduct;

microwave diathermy uses electromagnetic

radiation
Physiologic Effects
Radio frequency waves produced by diathermy

devices that pass through the tissues of the body are

not detected --> as energy is absorbed by the

tissues, temperature also gradually increases

"feeling of warmth"
Affects deeper tissues than superficial modalities

such as HMP
Minimal reflection of waves (SWD)
Heats larger areas than ultrasound
 Physiologic Effects
Thermal Effects
Vasodilation
Increased rate of nerve conduction
Elevation of pain threshold
Alteration of muscle strength
Acceleration of enzymatic activity
Increased soft tissue extensibility

Non- thermal Effects

Increased microvascular perfusion
Altered cell membrane function & cellular activity
Longwave Diathermy
Frequency: 1 MHz
Wavelength: 300 m
Most penetrating
No longer utilized due to high potential of causing

burns and interference with radio transmissions

Shortwave
Diathermy
Shortwave Diathermy
Frequency Wavelength

13.56 MHz 22 m

27.12 MHz 11 m

40.68 MHz 7.5 m

Shortwave Diathermy
Superficial & deep heating modality
Method of transfer: conversion
Manner of delivery: continuous or pulsed
Dosages:
Circuits
Primary circuit
Aka. machine/power circuit
Secondary circuit
Aka. patient circuit
Methods of Application
Capacitor Field Method
Inductive Method

Applicators:
Capacitive plates (SWD)
Inductive coil (SWD/PSWD)
Capacitive Method
aka. electric field method
Requires the patient's tissues to become part of a

capacitor
Capacitor - device that can store electrical charge and

consists of two conducting objects placed near each

other and usually separated by a dielectric

Dielectric - an insulating sheet placed between two

electrically charged plates = increased in capacitance

Capacitive Plates
Air space plates
Made out of metal encased

in plastic housing or

transmissive carbon rubber

electrodes that are placed

between pads
Concentrate in superficial

tissues
Capacitive Method
Selection of electrodes:
Electrode size
Smaller – superficial
Markedly larger – will travel through air
Ideal: Slightly larger – even heating
Capacitive Method
Spacing of electrodes:
Plates should be placed at an equal distance, ~ 1-3 in (2 - 10

cm) from the skin surface for optimal heating

4 cm (ideal) - heats deeper tissues
2.5 cm - minimum distance
Increased spacing = deeper tissues
Decreased spacing = superficial tissues
Single layer terry cloth
Capacitive Method
Electrode arrangements:
Contraplanar
Plates are placed on each side of the body part; Extremities
Coplanar
Plates are positioned parallel on the same side of the body; Neck, back, or pelvis
Monopolar
Only one electrode is placed over the treatment area and other electrode is

placed at a distance or is not used at all.

Crossfire method
One electrode is placed in one direction i.e. medial or lateral, while the other is

placed in different direction, i.e. anterior or posterior; Knee joint, sinuses, pelvic

organs, cavities
Inductive Method
aka. magnetic field method
Involves using an inductive applicator in which an

oscillating magnetic field induces oscillating

"eddy" currents
Uses both electric & magnetic field
Inductive Coils
Produce the most heat in tissues that have high electrical conductivity and

that are closest to the applicator.

Forms: Cables, garments, & drums
Cables - bundles of plastic-coated wires that are applied by wrapping

them around the patient's limb; not available

Garments - sleeves; have cables inside them that wrap around the

patient's limb when the garment is worn

Drum - made out of a flat spiral coil contained within a plastic housing
Monode: used to treat a single body surface; single layer of toweling
Diplode: a hinged drum that allows one or more body part surfaces to

be treated simultaenously; ~1 cm of toweling

SWD
Dosages:
Intensity - should have an intensity that causes sufficient

warmth (thermal dosage) of the tissues

Duration - 15-20 mins; may be given daily or on an

alternate day
Pulsed

SWD
PSWD
aka. "pulsed electromagnetic energy or field" (PEMR or

PEMF)
Created by simply interrupting the output of continuous

shortwave diathermy at regular intervals; aka pulse or

burst
Non-thermal
Physiologic Effects
Increased cellular activity
Increased hematoma reabsorption
Reduced inflammation
Reduced swelling
Increased repair process
Parameters
Frequency: 27.12 MHz with interpulse interval or off-time

added
Pulse frequency: 1 - 1000 pps
Pulse width: 40 - 400 ms
Pulse power: 100 - 1000 W
Duration: 30 - 60 mins; once or twice daily

INDICATION: Acute conditions

CONTRAINDICATIONS: All electromagnetic C/I
Parameters
Average power formula:

peak power (W) × pulse duration (s) × pulse frequency =

average power
Microwave
Diathermy
MWD
Use of microwaves for various therapeutic purposes
Generates high frequency electrical currents through a

"magnetron" oscillator
Generates alternating current at a high power level -->

antenna inside an emitter (drum or applicator) -->

electromagnetic field to the body part to be treated

Can be used for rehabilitation of small areas of tissue
Malignant tumors by hyperthermia
Tissues with high electrical conductivity = increased heat
Superficial heating
Microwave Diathermy
Frequency Wavelength

915 MHz 33 cm

2450 MHz 12 cm
Parameters
Dosages:
Intensity - should have an intensity that causes sufficient

warmth (thermal dosage) of the tissues; depends on

patient's sensation
Duration - 20 mins; may be given once or twice daily or

on an alternate day
Indications
Most indications for thermotherapy are indicated for

diathermy
Advantage:
Provides a greater depth of heating than superficial

thermal modalities
Can heat a larger area (greater amount of tissue)
Contraindications
Precautions
Related dangers
BURNS
Can cause soft tissue burns
Fat layers are at greatest risk
Patient's skin should be kept dry by wrapping towels to

avoid scalding by hot perspiration

Documentation
The following should be documented:
Area of the body treated
Frequency range
Average power or power setting
Pulse rate
Time of irradiation
Type of applicator
Treatment duration
Patient positioning
Distance of the applicator from the patient
Patient's response to treatment
Thank You
ANY QUESTIONS?