Short wave Diathermy

the practical part of short wave Diathermy

1. Short wave diathermy “SWD” - practical By: Mostafa Elwan

2. Physical properties: Shortwave radiation is within the radiofrequency range( 3 kHz to 300 MHz and wavelengths of 1 m to 100 km) the frequency used for medical purpose about 27.12 MHz and wavelength of 11 meter

3. Procedures : Evaluate the patient’s problem and determine the goals of treatment Confirm that diathermy is the most appropriate intervention Determine that diathermy is not contraindicated Explain the procedure and the reason for applying diathermy to the patient and the sensations the patient can expect to feel.

4. Select the m ood of application: There are two types of SWD Continuous shortwave → wrap around the treatment area towel to absorb local perspiration Pulsed shortwave (PSWD): The patient will receive a lower dose of SWD energy if compared with continuous SWD applied of the same time. Disposable cloth or plastic covering can be used over the applicator when treating conditions in which there is risk of infection.

5. Select the m ood of application: There are two types of SWD Continuous shortwave → wrap around the treatment area towel to absorb local perspiration Pulsed shortwave (PSWD): The patient will receive a lower dose of SWD energy if compared with continuous SWD applied of the same time. Disposable cloth or plastic covering can be used over the applicator when treating conditions in which there is risk of infection.

6. Select the method of application: 1. Capacitive method ( the electric field method ) A. Air Space Plates: Two electrodes and the p atient is part of the circuit . Resistance to the current flow in the tissues →results in tissue heating. Resistance (heat) will be higher for fat tissue than for muscle →should not be placed over areas of thick subcutaneous fat Used when the direct contact with the patient skin is not tolerable. Parallel placement of electrodes Equal electrode size Equal air space: approximately 2 to 10 cm (1 to 3 inches) from the skin surface

7. Select the method of application: 1. Capacitive method ( the electric field method ) A. Air Space Plates: Two electrodes and the p atient is part of the circuit . Resistance to the current flow in the tissues →results in tissue heating. Resistance (heat) will be higher for fat tissue than for muscle →should not be placed over areas of thick subcutaneous fat Used when the direct contact with the patient skin is not tolerable. Parallel placement of electrodes Equal electrode size Equal air space: approximately 2 to 10 cm (1 to 3 inches) from the skin surface

8. Method of application: 1. Capacitive method A. Air Space Plates

9. Method of application: 1. Capacitive method A. Air Space Plates

10. Method of application: 1. Capacitive method B. pad electrodes

11. Method of application: 2. inductive method ( also known as the magnetic field method ) A. cable or coil electrode The cable is coiled flat like a pancake and placed on the skin with turns of the cable spaced at least 3 cm apart. Rubber or wooden spacers can be use to separate coil folds Patient is placed in a magnetic field NOT part of an electrical circuit. Greatest amount of heating—occurs in low-impedance (high-conductivity) tissues containing the highest electrolyte content, such as skeletal muscle and blood. Less heating occurs in high-impedance tissues such as skin and fat.

12. Method of application: 2. inductive method A. cable or coil electrode Current flowing within the coil produces a rotating magnetic field (eddy currents) and heat generated due to the produced friction. The coil should be placed over the area to be treated and separated by six to eight layers of towels.

13. Method of application: 2. inductive method A. cable or coil electrode the cable is wrapped around the treated segment or region. Patient is placed in a magnetic field NOT part of a circuit

14. Method of application: 2. inductive method B. Drum electrode A drum applicator is made of flat spiral coil inside a plastic housing Monode or diplode. The center of the applicator should be placed over the area to be treated the drum should be placed directly over and close to the skin or tissues to be treated with a slight air gap to allow for heat dissipation

15. Method of application: 2. inductive method B. Drum electrode

16. Method of application: 2. inductive method C. induction sleeve Sleeves are designed to fit around a body part, such as the elbow and forearm

17. Capacitive (electric field) diathermy will cause greater heating in skin and subcutaneous fat tissue than muscle . Inductive (magnetic field) diathermy will more effectively heat muscle than capacitive diathermy with less heating of skin and subcutaneous tissue .

18. Precautions: Remove all metal jewelry and clothing from the area to be treated → to avoid any interaction with metal. Clean and dry the skin and inspect it if necessary. Position the patient comfortably on a chair or plinth with no metal components (only wood). Position the patient so that the area to be treated is readily accessible.

19. Electrode placements: Positioning of electrode in capacitive method Contraplanar technique: best for applying diathermy to extremities Coplanner technique: Cross fire technique

20. Electrode placements: Positioning of electrode in capacitive method Contraplanar technique: Coplanner technique: The distance between adjacent ends must be greater than the sum of skin electrode distance (A+B) best for treating the neck & back. Cross fire technique

21. Electrode placements: Positioning of electrode in capacitive method Contraplanar technique: Coplanner technique: Cross fire technique: Best applying in sinusitis & pelvic.

22. Factors affecting field distribution Capacitive Electrodes

23. Installation setting Tune on the SWD device : allow it to warm up according to the manufacturer’s directions adjusts the frequency, duration and intensity Gradually increase the level of the intensity→ produce a sensation of mild warmth in the patient The Desir sensation: the patient should feel a comfortable sensation of mild warmth with no increase in pain or discomfort. Continues SWD is generally applied for about 20 minutes. Most nonthermal PSWD treatments are administered for 30 to 60 minutes once or twice a day, 5 to 7 times a week. Provide the patient with a bell or other means to call for assistance during treatment. Instruct the patient to turn off the device and call immediately if he or she experiences excessive heating or an increase in pain or discomfort

24. Installation setting Cont. After 5 minutes, check to be certain that the patient is not too hot or is not experiencing any increase in symptoms When the treatment is complete, turn off the device, remove the applicator and towels, and inspect the treatment area. It is normal for the area to appear slightly red, and it may also feel warm to the touch. Assess the outcome of the intervention: reassess the patient, checking particularly for any signs of burning and for progress toward the goals of treatment. Remeasure quantifiable subjective complaints and objective impairments and disabilities. Document the treatment. Don’t forget to check the electrodes integrity.

25. Case study Male 22 years old referred to your clinic after falling in his knee during football match 2 days ago and your find the following: Swelling in Right knee Limited knee flexion Rang of motion Pain - What is the appropriate electrotherapy modalities can be used and? Mention it is parameter?

26. https://www.youtube.com/watch?v=yrJ8llUqPhg https://www.youtube.com/watch?v=hrl4dqR-co8