HIGH FREQUENCY

WAVES & SOUND

WAVES
GUIDE TO CLINICAL DECISION MAKING WITH DEEP
HEATING MODALITIES

Prepared by: Pethuel M. Pomaloy

Edited and Presented by: Jorell Victor S Angeles, PTRP
DLSMSHSI CRS PT Department
H F R E Q U E N C Y WAV E S A N D S O U N D WA
E L E C T R O M A G N E T I C WAV E S
• waves of energy that are propagated through space
• Composed of moving electric and magnetic fields

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 ELECTROMAGNETIC spectrum
• Electromagnetic waves are grouped according to their energy,
frequency, and wavelength, known as the electromagnetic spectrum
• Frequency - is the number of cycles of waves per unit time
• Wavelength – is the horizontal distance between the crest of any two
adjacent waves. Electromagnetic waves are measured in nanometer
(nm)

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT
Department
ELECTROMAGNETIC spectrum
• The wavelength of the electromagnetic spectrum is inversely
proportional with the frequency.

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
I S U LT R A S O U N D PA RT O F
THE ELECTROMAGNETIC
SPECTRUM?
 U LT R A S O U N D
• No. US is high-frequency mechanical waves delivered using acoustic
energy. But both produces waves of energy.
• US waves need a medium / coupling agent to transmit efficiently
whereas EM waves can travel even on a vacuum.

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 HOW CAN FREQUENCY
A N D WAV E L E N G T H
AFFECT THE DEPTH OF
P E N E T R AT I O N O F T H E
DIFFERENT MODALITIES?
P E N E T R AT I O N V S . A B S O R P T I O N
• absorption of superficial tissues are greater in modalities with shorter
wavelength and higher frequencies
• all the energies are easily absorbed in the superficial tissues and
therefore lesser energies penetrate the deep seated tissues

• Question: You want to use therapeutic effects of ultrasound to bone.

What head to use ? 3 MHz vs. 1 MHz?

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 IN CHOOSING A
M O D A L I T Y, H O W C A N
KNOWLEDGE
OF THE SPECTRUM HELP
IN DETERMINING
U LT R A S O N I C O R
ELECTROMAGNETIC
ABSORPTION
 B E E R L A M B E RT ’ S L AW
• the degree of tissue absorption and wave attenuation depends on the
wavelength of the radiation and the nature of the absorbing material
• More thick and More dense = more absorption
• Longer wavelength = lesser absorption

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 OTHER PRINCIPLES: quantum
energy theory
• energy contained in individual quanta is greater in higher frequencies.
• Ex. the antibacterial property of UVR because it is situated in the
higher frequency end of the spectrum

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 OTHER PRINCIPLES: arndt-
schulz law
• Certain minimum stimulus is needed to initiate a biological process.
Although a slightly stronger stimulus may produce greater effects,
beyond a certain level, stronger stimuli have a progressively less
positive effect.

Intensity range:
+ Sub-threshold energy = no change
+ Threshold = stimulate absorbing tissue
+ Too great energy = destroys tissue.
Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT
Department
 OTHER PRINCIPLES: COSINE
L AW
• Electromagnetic energy is most efficiently transmitted to the tissues
when it strikes the body at a right angle (90 degrees).

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
OTHER PRINCIPLES: INVERSE
S Q U A R E L AW
• The intensity of radiation varies
inversely with the square of the
distance from the source.
• Doubling the distance between the
tissue and the energy decreases the
intensity at the tissue by a factor of
four

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 OTHER PRINCIPLES: Bunsen-
r o s c o e ’s l a w o f r e c i p r o c i t y
• The intensity & duration of dose of radiant energy are inversely
proportional.
• In order to keep the amount of energy constant, an INCREASE in
intensity must be accompanied by a DECREASE in duration and vice-
versa

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 OTHER PRINCIPLES:
G R O T T H U S - D R A P E R L AW
• Rays must be absorbed to produce an effect

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 OTHER PRINCIPLES: WIEN’S
L AW
• the wavelength of maximal emission is inversely proportional to the
absolute temperature of the source. Hot sources will emit shorter
wavelength.

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
BIOPHYSICAL PRINCIPLES OF
R A D I AT I O N
• direction of propagation of radiant energy is normally a straight line.
However, these waves of energy can be transmitted, reflected,
refracted, and absorbed by the media through which they travel

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
BIOPHYSICAL PRINCIPLES OF
R A D I AT I O N
• Reflection  The shorter the wavelength, the greater the
reflection.
• Refraction  The greater the difference in densities, the greater
the refraction.
• Absorption  Maximum absorption takes place when the rays
strike at right angles.
• Penetration  also depends on the frequency and wavelength.

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT
Department
 CLINICAL PEARL: THE
INTENSITY OF THE
ELECTROMAGNETIC
R A D I AT I O N R E A C H I N G
T H E B O D Y I S G R E AT E S T
WHEN ENERGY OUTPUT
I S H I G H , T H E R A D I AT I O N
SOURCE IS CLOSE TO
T H E PAT I E N T, A N D T H E
 TYPES OF HIGH FREQUENCY
electrotherapy MODALITIES
• Diathermies
• Infrared Radiation (Infrared lamps)
• Ultraviolet Radiation (Ultraviolet Therapy)
• LASER (“light amplification by stimulated emission of radiation.” )
• Ultrasound*

Used for Thermal and Nonthermal effects

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 D I AT H E R M I E S
• The term diathermy literally means to “heat through.”
• use of electromagnetic waves from the radio frequency or microwave
frequency ranges for thermal effects

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 INFRARED LAMPS
• Between visible light and
microwaves
• Emit electromagnetic radiation
within frequency that gives rise
to heat

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 U LT R AV I O L E T R A D I AT I O N
• Use of Electromagnetic radiation using wavelengths at 400-290 nm
(lies between X-rays and Visible light)
• Effects: Bactericidal (wound), skin erythema, tanning, epidermal
hyperplasia, vitamin D synthesis
• Used for Psoriasis and other Skin Disorders

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 LASER
• Generally used to promote tissue healing and to control pain and
inflammation by thermal and nonthermal mechanisms

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 PHYSIOLOGIC EFFECTS OF
E L E C T R O M A G N E T I C R A D I AT I O N
 PHYSIOLOGICAL EFFECTS
• Thermal
• Non-Thermal

• The physiologic and clinical effects of thermal agents are generally the
same as the effects of superficial heating

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 Thermal EFFECTS
1. Decreasing inflammation and facilitating healing.
2. Pain modulation
3. Alter collagen extensibility.
4. Modify muscle tone.
5. Altering nerve conduction or sensitivity.

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 Parameters in selecting an
appropriate heating modality
• Determine if the part to be treated is superficial or deep
• Determine the desired effect
• Determine if the condition is indicated or contraindicated for the
modality
• Be aware of the factors that modify tissue temperature distribution

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 C O N T R A I N D I C AT I O N S V S .
PRECAUTIONS
• Absolute contraindication means that the modality or protocol must not be used under
any circumstances
• Relative contraindications mean that the treatment can be modified to accommodate
the patient’s condition
• Precautions identify how misuse of the modality can cause harm to the patient.

• Pregnancy
• Malignancy
• Impaired sensation and mentation
• Implanted electronic devices
• Acute DVT / thromboplebitis
Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT
Department
PRESCRIPTION GUIDELINES
• Intensity (Modality specific)
• Frequency (# of times in a day / week)
• Position of the patient / draping
• Precautions and special considerations

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 M o n i t o r i n g & C h a r t i n g P a t i e n t ’s
Response and Progress
• Is the treatment achieving or meeting the desired effect?
• Are there any adverse reactions noted?
• Are there other conditions that may affect or complicate the treatment?
• Did the treatment meet the patient’s expectations?

Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT

Department
 QUESTIONS?
THANK YOU FOR LISTENING!
Prepared by: Pethuel M. Pomaloy DLSMSHSI CRS PT
Department