Shortwave and Microwave

Diathermy

Jennifer Doherty-Restrepo, MS, LAT, ATC

Entry-Level ATEP
Therapeutic Modalities
 Diathermy
Application of high-frequency
___________________ energy
______________ diathermy
Used to generate ______ in body tissues
______ produced as a result of the __________ of
tissues to the passage of energy
___________ diathermy
Used for ________________ effects
Renewed interest due to research documenting
efficacy
 Physiologic Responses To
Diathermy: Thermal Effects
Tissue temperature __________
Increased blood flow (vasodilation)
___________ venous and lymphatic drainage
___________ metabolism
Changes in physical properties of tissues
Muscle _________
Analgesia
 Diathermy Heating

Diathermy parameters are not precisely

controlled, thus the amount of heating
cannot be accurately measured
Heating occurs in proportion to the square
of the current density and in direct
proportion to the resistance of the tissue
Heating = ______ X ________
 Physiologic Responses To
Diathermy: Non-Thermal Effects
Pulsed shortwave diathermy is used to treat ________
injuries and wounds
Mechanism of effectiveness is related to the
_____________ of damaged cells
Loss of cell division
Loss of proliferation
Loss of regenerative capabilities
____________ occurs with treatment, thus correcting
cell dysfunction
Not capable of producing _____________ to elicit
muscle ______
Wavelengths too short
 Shortwave Diathermy

Shortwave diathermy unit is a radio

transmitter
Three frequencies available:
______ MHz, wavelength of 11 m
______ MHz, wavelength of 22 m
______ MHz, wavelength of 7.5 m
 Shortwave Diathermy Unit
_______________: provides power to radio
frequency oscillator (RFO)
____: provides stable, drift-free oscillations at
given frequency
_____________: generates power to drive
electrodes
__________________:tunes in the athlete as part
of the circuit to allow for maximum power transfer
 Shortwave Diathermy Unit

A =Power switch
B = Timer
C = Power meter
Monitors current from power supply, not current entering patient
D = Output intensity (% max power to patient)
E = Tuning control (tunes output from RFO)
 Shortwave Diathermy Unit
Power output should provide energy to ______
tissue temperature to therapeutic range
Therapeutic range = ___________
____________________________: represents
the rate of energy absorbed per unit area of
tissue mass
Power range required to elicit tissue temperature
increase = ____________
 Adjusting the
Shortwave Diathermy Unit
________________: adjusts patient circuit
Set output intensity at ______ of maximum
Adjust tuning control until power output meter reaches
______
Then adjust down to ______________, which is about
50% of maximum output
If patient is able to tolerate more than 50% of
maximum output, he/she is ___________________
________________: automatically sets output
intensity
Automatically turns off if patient is _______________
 Shortwave Diathermy Unit
Generates both an _______ and a _______
field
Ratio depends on characteristics of both the
______ and the _________
SWD units at 13.56 MHz = stronger ________
field
SWD units at 27.12 MHz = stronger ________
field
 SWD Electrodes
2 types of electrodes
_____________________
Air space plates
Pad electrodes
_____________________
Cable electrodes
Drum electrodes
Selection of appropriate electrodes can
influence the treatment
 Capacitor Electrodes
Create stronger ______ field than ______ field
Ions will be attracted or repelled depending on the
charge of the ______
Capacitor Electrodes

Electrical field
Lines of force exerted on
charged ions that cause
_____________________
________________r
______ has higher current
density than __________
Capacitor Electrodes

Patient is between
electrodes
Becomes part of circuit
Tissue is between
electrodes
__________ circuit
arrangement
 Electrical Field
The tissue that offers the greatest resistance
to current flow develops the __________
Fat tissue ______ current flow
Therefore, tissues with a ______ fat content
are heated in an electrical field
Typical with capacitor-type electrodes
Capacitor Electrodes:
Air Space Plates
Two metal plates surrounded
by glass or plastic guard
Metal plates can be adjusted
3cm within guard
Produce ________________
oscillating current
When one metal plate is
overloaded, it discharges to
other plate of lower potential
Capacitor Electrodes:
Air Space Plates
Area to be treated is
placed between
electrodes
Treatment area becomes
part of the external
circuit
 Capacitor Electrodes:
Air Space Plates

Sensation of heat in _____ proportion to the distance of

metal plate from the skin
The closer the plate to the skin, the _____ the energy
transmission (______ reflection)
Generates more surface heat in ____ and _____________
 Capacitor Electrodes:
Pad Electrodes
Greater ______ field than ______ field
Patient is between electrodes
Becomes part of external circuit
Capacitor Electrodes:
Pad Electrodes
Must have uniform
contact pressure on the
body
Toweling to prevent burns
Spacing between
electrodes is equal to the
____________ ________
of pads
Capacitor Electrodes:
Pad Electrodes

Area to be treated
should be ______
between electrodes
Increasing the space
between electrodes
will ______ the depth
of penetration but will
_________ the current
density
Vice versa also true
 Induction Electrodes
Creates a stronger ________ field than ________
field
A cable or coil is wrapped circumferentially
around an extremity or coiled within an electrode
Passing electrical current through coiled cable
creates a ________ field by inducing ________
_________
Small circular electrical fields that generate heat
 Induction Electrodes
Patient placed in a magnetic field
NOT part of a circuit
Tissues in treatment area are in _________
arrangement to magnetic field
Greatest current flow through tissue with least
resistance
Tissue high in __________________ respond
best to a magnetic field
Induction Electrodes:
Cable Electrode
Two arrangements:
Pancake coils
Wraparound coils
Requires at least ____ of
toweling between skin
and coil
Spacing between turns in
coil must be ______
Induction Electrodes:
Drum Electrode
One or more monopolar
coils rigidly fixed in a
housing unit
May use more than one
drum depending on
treatment area
Toweling important to
prevent ______
Continuous Shortwave Diathermy
Patient sensation provides basis for
recommendations of continuous SWD
Dose I (______): no sensation of heat
Dose II (______): mild heating sensation
Dose III (______): moderate or pleasant heating
sensation
Dose IV (______): vigorous heating with pain
threshold
 Pulsed Shortwave Diathermy

Pulsed electromagnetic energy (PEME)

Pulsed electromagnetic field (PEMF)
Pulsed electromagnetic energy treatment
(PEMET)
Pulsed Shortwave Diathermy
 Pulsed Shortwave Diathermy
Interrupted output delivered in series of
high-frequency bursts (______)
______ _____selected with pulse frequency
control
Off-time ______ than on-time
Mean power output is ______
Uses drum electrode
 Shortwave Diathermy vs. Ultrasound

Pulsed
SWD produces the same magnitude and depth
of muscle heating as 1 MHz ultrasound
(Draper, JAT 1997)
 Shortwave Diathermy:
Treatment Time
Typically, 20 - 30 minutes
Reminder:
As skin temperature rises, resistance falls
 Microwave Diathermy
Two frequencies available:
2456 MHz
915 MHz
______ frequency and ______ wavelength as compared
to shortwave diathermy
Generates strong ______ ______ and relatively little
________ field
Depth of penetration is minimal in areas with
subcutaneous fat > 1 cm
 Microwave Diathermy Unit

A = Power switch
B = Timer
C = Output meter (indicates relative output in Watts)
D = Power output level knob
E = Amber light - warming up; Red light - ready
Microwave Diathermy Electrodes

Circular-shaped electrodes
4 or 6 in diameter
Maximum temperature at periphery
Rectangular-shaped electrodes
4.5 x 5 or 5 x 21
Maximum temperature at center
 Microwave Diathermy:
Electrode Set-Up
915 MHz units
Electrodes are placed 1 cm from skin
2456 MHz units
Manuel includes manufacturer recommended
distances and power outputs (uses antenna)
Reminder: Cosine Law
Energy should be administered at ______ to reduce
______
 When Should Diathermy
Be Used?
If the skin or some underlying soft tissue is
tender and is unable to tolerate pressure
When The Treatment Goal Is To Increase
Tissue Temperatures In A Large Area
In areas where subcutaneous fat is thick and
deep heating is required