Shortwave Diathermy

Question 1

Purpose of diathermy capacitative plates

Answer 1

• Heat large, deep areas of tissue
• Increase circulation in superficial tissues
• Increase extensibility in deeper tissues
• Increase microvascular perfusion
• Increase local tissue oxygenation
• Increase cell growth and phagocytosis

Question 2

Indications for diathermy capacitative plates

Answer 2

• Pain control
• Accelerated tissue healing
• Decrease joint stiffness
• Increase joint range of motion
• Control edema
• Soft tissue, nerve, and bone healing
• Improve osteoarthritis symptoms

Question 3

Diathermy drums set up

Answer 3

1. Evaluate the patient
2. Determine the appropriateness and safety of the treatment
3. Select a device
4. Prepare the patient by removing metal and clothing in the treatment area
5. Clean, dry, and inspect the skin
6. Wrap the treatment area
7. Position the patient and the device
8. Tune the device
9. Select the treatment parameters
10. Turn the machine on
11. Assess the patient at 5 minutes of treatment for any adverse effects
12. Provide a way for the patient to reach the clinician during treatment as needed
13. Assess outcomes after treatment

Question 4

Patient positioning with diathermy

with each type of applicator

Answer 4

• Inductive applicator: place the drum or plate directly over and close to the skin or tissue to be treated
• Capacitive applicator: place the two plates 2-10 cm from the skin and equal distance on either side from the treatment area
• Magnetron applicator: place a few inches from the area to be treated and direct it toward the skin

Question 5

SWD description

Answer 5

• offers heat by the conversion of high frequency electromagnetic energy to heat energy in patient tissue

Question 6

SWD parameters

Answer 6

• short wave band: 27.12 MHz
• continuous or pulsed

Question 7

types of applicators

Answer 7

• inductive coils - SWD/PSWT
• capacitive plates - SWD/PSWT

Question 8

induction field

Answer 8

• heat superficial and deep
• strongest where the density of the field is greatest, usually closest to the applicator
• greatest in tissues with highest electrical conductivity: muscule and synovial fluid

Question 9

Capacitive Plates

Answer 9

• high frequency alternating electrical currnet flows from one plate to another
• condenser field uses the patient’s tissues as the dielectric between two conducting electrodes
• current causes oscillation of charged particles and increase tissue temperature (heat greates with strength of currnt and tissues with highest conductivity)

Question 10

Thermal - SWD

effect

Answer 10

• Vasodilation
• increase rate of nerve conduction
• elevation of pain threshold
• alteration of muscle strength
• acceleration of enzymatic activity
• increased extensibility of soft tissue
• heats superficial and deep tissues

Question 11

Advantages of SWD

Answer 11

• SWD may reach deeper tissues versus opposed to radiant or conductive heat
• can be used for larger areas of tissue than US
• rate of heat decay is slower than with continuous US

Question 12

Clinical applications

of SWD

Answer 12

• thermal skin test
• pain control
• accleration of tissue healing
• decreased joint stiffness
• increased joint ROM

Question 13

PSWT non thermal

treatment settings

Answer 13

• acute condition: <3 watts
• subacute: <5 watts
• chronic: >5 but <12 watts
• 15-20 minutes

Question 14

US targetes what tissue

Answer 14

• dense collage based tissue
• ligments
• tendon
• fascia
• joint capsule
• scar tissue

Question 15

pulsed shortwave targtes what type of tissue

Answer 15

• wet, ionic, low, impedance tissues
• muscle
• nerve
• areas of edema
• hematomas and effusion

Question 16

laser targets what types of tissues

Answer 16

• superficial vascular tissues
• open wounds
• muscle
• nerves
• tendon sheath

Question 17

clinical applications of PSWT

Answer 17

• useful if heating is contra-indicated or not wanted
• control of pain and edema
• soft tissue, nerve and bone healing
• improvement in OA symptoms

Question 18

SWD:
- depth of tissue
- size of area treated
- treatment time
- type of tissue

Answer 18

• depth of tissue: 3-5 cm
• size of area treated: larger
• treatment time: 20-30 minutes
• type of tissue: muscle fat, skin

Question 20

US thermal:
- depth of tissue
- size of area treated
- treatment time
- type of tissue

Answer 20

• depth of tissue: 2-3 cm
• size of area treated: smaller
• treatment time: 5-15 minutes
• type of tissue: tendon, ligament, joint capsule

Question 21

Moist heat pack:
- depth of tissue:
- size of area treated:
- treatment time:
- type of tissue:

Answer 21

• depth of tissue: 1-2 cms
• size of area treated: larger
• treatment time: 20 minutes
• type of tissue: skin, superficial muscule

Question 22

Contra-indications of SWDand PSWT

Answer 22

• patients, staff or visitors with PACEMAKERS
• implanted systmes or implanted leads
• over pregnant uterus

Question 23

Contraindications of SWD

Answer 23

• METAL in treatment site
• malignancies
• epiphysis of growing bones
• eyes or tests
• general contraindications of heat

Question 24

Precautions with SWD/PSWT

Answer 24

• magnetic equipment, hearing aids, watches
• avoid or correct situations that tend to concentrate the field (ischemic areas, metal, open wounds or moist dressing, uneven spacing of electrodes, persipration)
• patients with poor thermal sensation
• adipose tissue has high electrical resistance obese patients may experience excessive heat superficially therefore avoid capacive plate method

Question 25

Precautions for the therapist with SWD

Answer 25

• diathermy produces diffuse radiation
• stay at least 1-2 metes away from continuous applicators
• avoid SWD exposure during pregnancy

Question 26

How to midigate burns from SWD

Answer 26

• thermal skin test prior
• take a good history
• patients skin must be kept dry by wrapping with towels