Diathermy & Laser Flashcards
What is diathermy?
- “To heat through”
- use of short wave electromagnetic energy causes increase kinetic energy resulting in heating of tissues
Indications and effects for use of diathermy:
- Conditions that benefit from use of heat (joint capsule contractures, shortened soft tissues, muscle spasms, etc.)
- Sensitivities to pressures (like a hot pack) due to radiating form of energy transfer
- Minimally heats up skin and subcutaneus fat
- Physiological Effects: Increased blood flow, cell metabolism, and tissue elasticity. Decrease joint viscosity, results in increased mobility
Problems regarding the use of diathermy:
- Safety concerns:
- emission of stray radiation during treatment
- potential burn if too close to skin
Diathermy Contraindications:
- If operator is pregnant
- Over areas with impaired sensation
- Over areas with metallic implants
- Over metallic jewelry or near metallic areas in environment
- Over cancerous areas
- Over abdominal/ pelvis of pregnant women
- Hemorrhagic areas
- Ischemic Areas
- Over Testes and Eyes
- Over epiphyses of growing children
- Over copper-bearing intrauterine devices (for this class)
- Thrombophelbitis
Neighboring patients (especially those wearing implanted electronic devices- must stand at least _________ from the DIATHERMY operating device)
10-15 feet away
Diathermy operator’s exposure to electromagnetic waves during patient
treatment should stand ______ from unit and ______ from cables)
- 3 feet from device
- 1.5 feet from cables
What are the types of diathermy applicators?
- Electric Field Method - capacitor (superficial): absorberd better by low water content tissues (high impedance tissues like skin and sub-cutaneous fat)
- Magnetic field method - coil (deeper): absorbed better by high water content tissues like muscles and synovial fluid). Over flat larger areas.
High impedance tissues means that…
Tissues allows a relatively small amount of current through
e.g skin and subcutaneus fat
Low impedance tissues means that?
e.g.?
Tissue allow a large amount of current thrugh
e.g. Muscle tissue
General Procedures for Applying Diathermy:
- Check contrainidications
- Consider risks
-
Position the patient comfortably on a chair or plinth with no metal components:
- clean, dry and inspect the skin
- Check skin sensation and circulatory status
- Draping if necessary
-
Explain the procedure and the reason for applying diathermy to the patient and the sensations the
patient can expect to feel.- CSWD (continous) & PSWD (pulsed shorwave): should feel a comfortable sensation of mild warmth without any increase in pain or discomfort
- Warn the patient that if it is hotter than is comfortable, notify PT immediately as failure to do so can result in a burn
- Remove metallic object from the treatment area
- Select device type: portable or cabinet
- Delivery mode: CSWD or PSWD
- Delivery method: capacitor (skin and sub-cutaneous fat) or coil (muscles and synovial fluid)
- set dosimetry
- apply tx
- remove applicator, inspect skin
What type of diathermy used on the knee, ankle, foot and shoulder?
capacitor, two plates
What type of diathermy used on shoulder, quads, back?
coil
Select mode of delivery (diathermy)
- Choose between CSWD and PSWD.
- Higher doses are better delivered by using the continuous mode, whereas the pulsed mode is preferable for lower doses.
Select method of application (diathermy):
* Choose between the capacitive or inductive method:
- Capacitive: a capacitor, for heating tissues with low water content and high impedance, such as skin and subcutaneous fat (superficial)
- Inductive: a coil, for heating tissues with high water content and low impedance, such as muscle and synovial fluid (deeper)
The capacitive method is capable of deep tissue heating if applied over patients who are lean (low fat index) because minimal heat absorption will occur in the subcutaneous fat. Conversely, the capacitive method is not recommended for patients who are overweight or obese.
Light Amplification by Stimulated Emission of Radiation
Laser
Laser used in Physical Therapy:
class?
mW?
Low-level laser therapy
class 3B
5 - 500 mW
Physical properties of laser
- Light source from photodiodes
- Monochromacity
- Coherence
- Collimation
Collimated light is light whose rays are parallel, and therefore will spread minimally as it propagates
Effects of laser:
- Alters cellular behavior without heating the tissues
- Induces a photobiomodulation effect on biological tissues
- Photobiostimulation
- Promote Adenosine Triphosphate Production
- Promote collagen production
- Modulate inflammation
- Inhibit bacteria growth
- Promote vasodilation
- Alter nerve conduction velocity and regeneration
Clinical Indications for laser:
- pain mgmt
- tendinopathy mgmt
- dermal wound mgmt
Laser over Direct irradiation of the eyes:
no, contraindicated
Laser over malignant tumor?
no, contrainidicated
laser over the abdominal and pelvic area of pregnant women
no, contrainidicated
Wavelenght of laser:
Between 500 and 1100 nm
laser over the hemorrhagic region
no, contraindicated
laser over the heart, vagus nerve, and sympathetic region of
cardiac patients
no, contraindicated
laser over the thyroid gland?
no, contrainidicated
laser over photosensitive skin area
no, contraindicated
Laser Contraindications:
- Direct irradiation of the eyes
- Over malignant lesion
- Over the abdominal and pelvic area of pregnant women
- Over the hemorrhagic region
- Over the heart, vagus nerve, and sympathetic region of cardiac patients
- Over the thyroid gland
- Over photosensitive skin area
Adverse effects of laser
- Mostly no adverse effects
- Reports of transient tingling, mild erythema, a burning sensation, an
increased pain, numbness, and skin rash - Primary hazard: Irradiation of the eyes:
- Can cause retinal damage if viewed along the beam
