Swd

ortho and physio

1. SHORTWAVE DIATHERMY Dr.Ankit Desai Dr.B.L Chandrakar

2. Def .: SWD is a modality that produces deep heating via conversion of electromagnetic energy to thermal energy . The pattern of heat produced depend on: ᴥFreq . used. ᴥ type of SWD unit. ᴥwater content of the tissues. Shortwave diathermy current freq. 10 – 100 M Hz (The shortest radiofrequency wave is used in therapeutic diathermy.) the commonly used in medical work having freq. of 27.12 MHz with wavelength of 11 meters Modalities: ether continuous or pulsed (PSWD). PSWD : application of series of short pulses of SWD so that short periods of SWD interrupted by gaps where there is no SWD. The pt. receives lower dose of SWD energy if compared with continuous SWD applied of the same time. The tissues will receive lower thermal load. SWD : produce both deep and sup. Tissue heating , under certain controlled conditions it’s applied for 20 min at the max tolerable dose . SWD produced by an oscillating electric current of extremely high frequency .

3. Therapeutic effect: Increase blood flow . Help resolution of inflammation. accelerate wound healing. ↗ extensibility of deep collagen tissues. ↘ joint stiffness . Relief deep mus. Pain & spasm . ( via muscle spindle & Golgi tendon organ stimulation)

4. Clinical indications: Resent burns. Recent injuries. Plastic surgery. Postoperative Post laminectomy pain. Sinusitis TMJ disorders. Bell’s palsy. Sub deltoid bursitis ass. With calcification. Chronic arthritis Degenerative complaints. PID (pelvic infla. Dis.) ↘pain ass. With herpes zoster.

5. Exp. Of SWD application in various cond.: Soft tissues healing: SWD ++ earlier maturation of collagen fibers. raped regeneration of damaged ms. fibers. PSWD more raped activity in collagen formation. enhance rate of skin healing. Resolution of haematoma: enhance rapid resolution. Recent ankle injuries PSWD  more effective improve: pain, swelling, disability. Pain: relief pain ass. With various cond. E.g.: back pain. PSWD relief pain ass. With acute injuries. Nerve regeneration: PSWD accelerate recovery of nerve conduction. O.A: SWD & PSWD forming part of physiotherapeutic modalities used in OA ttt.

6. contraindications: I mplanted pacemaker. Metal in the tissues or ext. fixators. Impaired thermal sensation. Over pregnant uterus & intrauterine devises. Hemorrhagic areas ( menses ). Ischemic tissues. Recent thrombosis . Mlg. Tumors  ↗proliferation. Active TB. Pt. pyrexia. Areas of skin affected by courses of x-ray. Uncooperative pt . T (x) Temp ↗

7. Application of SWD: pt. is connected to the electrode circuit of the high freq. Generator by: A) capacitive applicator or B) inductive coil

8. A) capacitive applicator: 2 diff. types of electrodes for applying the capacitive method: Flexible metal plate  malleable electrodes Rigid metal discs  disc electrode (more commonly used method. Uses the patient’s tissues as a part of the circuit The tissues’ electrical resistance produces heat Selectively heats skin Muscle is heated via conduction from the adipose Also referred to as “condenser field diathermy”

9. capacitive applicator .. Cont The pt. is placed between 2 metal condenser plates.  Achieve higher temperature in water-poor tissues, (like: sub. Cut. Adipose tissue, lig, tendons, joint capsule, Bone.) Guid lines for electrode selection & placement: Electrode should be of equal size Electrode should be slightly larger than the body part  electric field is less uniform at the edge of the plate. Electrode should be equidistant & at right angles to the skin surface. Electrodes arrangement contraplanar application ( transverse):  an electrode is placed on either side of the limb. Coplanar application: both electrodes are placed on the same side of the limb. Longitudinal application:  one electrode is placed at each end of the limb.

10. B) Inductive application Based on ( electromagnetic induction) Use induction coils that apply a magnetic field to induce circular electrical field in the tissue. They achieve higher temperature in water-rich tissues. ( Like: ms. Skin. Blood ..etc.) Current flowing within the coil produces a rotating magnetic field Which produces eddy currents in the tissues Eddy currents cause friction that produce heat

11. Inductive application … cont. Induction SWD method  using magnetic induction to produce small eddy current in the tissues which ↗↗ tissue temp. 2 diff. applicators are used in this method: most commonly used  an inductive coil applicator Wrapping insulated cable around the limb to be ttt.

12. Dose determination using thermal sensation Pt. pain perception used to monitor heat intensity that is being produced. ( inaccurate method ) Therapist must be aware of the potential risk of causing tissue damage & ensure that the max dose that a pt. receives cause only a mild sensation of warmth . Towels are sometime placed to spacing & absorb sweet, which is highly conductive and could result in potentially sever focal heating. Typical ttt time is 20 to 30 minutes Acute cond . Should be ttt with low dose PSWD And chronic conditions should be ttt with high dose SWD .

13. TTT procedures Prepare the pt.: Exclude any C.I. Examine thermal & pain sensitivity of the pt. Ensure removal of any metal object (ring jewelry ..) from the ttt area. Ensure removal of any hearing aid. Contact lenses. Removal of all bandages & clothes from the ttt area. Ensure dryness of skin. Ask the pt. to report immediately any abnormal sensation felt during ttt. Ensure that the gonads aren’t subjected to irradiation.

14. TTT procedures … cont Prepare the machine: Ensure correct connection of cables. Ensure that cables & applicators aren’t placed on metal surfaces. Ensure appropriate alignment of the applicator for max energy transfer. Ensure that cables aren’t close to untreated tissues. Ensure that pt. support isn’t metallic & all metal objects are kept at least 3ms. Away from the applicators & cables. Correct wrong

15. TTT procedures … cont. Once the unit activated the operator should: Remain at least 1m from the cables Ensure that the pt. maintain correct position. Ensure that the pt. not left alone during ttt unless supplied with reliable cut-off switch. Ensure the pt. not touch the machine. Ensure that no other person is in the vicinity of the machine.

16. Dangers of SWD. Burns. Scalads . Faintness  due to ↘ BP . Ppt. of gangrene  if area of ↘blood supply Sparking  if one electrodes touched while application of current Electric shock . Over dose … ↗ pain.