DIATHERMY

What is DIATHERMY?
The use of non-ionizing
ionizing electromagnetic
energy from the radio-frequency
radio spectrum
as therapeutic agent
 Types of Diathermy

Long wave
- longest wavelength 300 30 m
- most penetrating
- no longer utilized due to high potential of
causing burns and interference with radio
transmissions
Shortwave
Microwave
SHORTWAVE DIATHERMY
Superficial and Method of Heat
deep heating Transfer
modality - Conversion
Frequency Manner of Delivery
- 27.12 MHz - continuous
Wavelength - pulsed
- 11 m
Continuous vs Pulsed SWD
 PULSED SWD

Pulse Repetition Rate (PRR)

- 15 to 800 Hz
Pulse Duration (PD)
- 25 to 400 microseconds
Peak Pulse Power (PPP)
- 100 to 1000 watts
Duration
- 20 minutes (5-15
15 acute; 10-20
10 chronic)
Calculating Mean Power in PSWD
1. Cycle Duration = 1000 / PRR

2. % cycle SWD delivered =

(PD x 100) / Cycle Duration

3. Mean Power delivered =

PPP x % cycle SWD
SHORTWAVE
DIATHERMY UNIT
 HEAT PRODUCTION

Dependent on:
SPECIFIC ABSORPTION RATE
Tissue conductivity
charged molecules
dipolar molecules
non--polar molecules
Electrical field magnitude
 Charged Molecules

Ions and certain

proteins
Molecules are
accelerated along
lines of electric force +

+
-
-

+
Most
Most efficient way of +
-

heat production
 Dipolar Molecules

Water and some

proteins
Positive pole of the
molecule aligns itself
to the negative pole
of the electric field
(vice versa)
Moderately
Moderately efficient
 Non-Polar Molecules

Fat cells
Electron cloud is distorted but negligible
heat is produced
Least efficient heat production
 Clinical Implication !

Blood, having high ionic content, is a

good conductor
vascular tissues as well
Metal and sweat are good conductors
if metal implants and sweat are present
within the electric field, may cause burn
SHORTWAVE DIATHERMY

Condenser Induction
Field Field
 CONDENSER FIELD

Patients tissues are used as DIELECTRIC

between the conducting electrodes
Oscillation and rotation of the molecules of
the tissues produces heat
Either flexible metal plates (malleable) or rigid
metal discs can be used as electrodes
Can be applied in 3 ways: contraplanar,
coplanar, or longitudinal
 Ways of Application

Contraplanar
- aka Transverse positioning
- plates are on either side of the limb
 Ways of Application

Coplanar
- plates parallel with the longitudinal
section of the body part; same side
 Ways of Application

Longitudinal
- plates are placed at each end of the limb
 In what way should
SWD be applied?

No conclusive evidence as to the technique of

application that will produce the most effect
on the heated tissue (Kitchen and Bazin, 1996)
 GUIDELINES !

Electrodes should be:

Equal in size
Slightly
Slightly larger than the area treated
Equidistant
Equidistant and at right angles to the
skin surface
 INDUCTION FIELD

Patient is in the electromagnetic field or

the electric circuit produce strong
magnetic field induce electrical
currents within the body (EDDY currents)

Utilizes either an insulated cable or an

inductive coil applicator
 Arrangement of Inductive Coil

Monode: coil
arranged in one plane
Hinged Diplode:
permits electrode to
be positioned at
various angles around
the three sides of the
body part, or in one
plane
 Which is more effective: condenser or induction field?

Some
Some studies argue that inductive diathermy
produces greater increase in temperature of
deeper tissues compared to
condenser/capacitive technique

Any
Any deep effects following capacitive
technique requires considerable increase in
superficial tissue temperature
 THERAPEUTIC EFFECTS
(continuous and pulsed)

Increase
Increase blood flow
Assist
Assist in resolution of inflammation
Increase
Increase extensibility of deep collagen
tissue
Decrease
Decrease joint stiffness
Relieve
Relieve deep muscle pain and spasm
 INDICATIONS

Soft tissue healing

- conflicting evidence as regards
effectiveness of SWD
- controlled animal studies revealed
insignificant results as well as trials
involving human subjects (Kitchen and
Bazin, 1996); to date, no studies in the
treatment setting was conducted
 INDICATIONS

Recent ankle injuries

- inconclusive results following three
double-blind
blind protocols (Kitchen and Bazin)
 INDICATIONS

A. Nerve Regeneration
Pain Syndromes - studies were done on cats
- Pulsed SWD may and rats
provide better - PSWD induced
regeneration of axons,
pain relief in some acceleration and recovery of
musculoskeletal nerve conduction
conditions (neck B. Osteoarthritis
and back) than - no established effect
SWD C. Post-operative
Post
MICROWAVE
DIATHERMY
Superficial and deep heating
Frequency: 300 MHz to 300 GHz
Wavelength: 1m to 1mm
Therapeutic Parameters:
A. 122.5 mm 2456 MHz
B. 327 mm 915 MHz
C. 690 mm 433.9 MHz
Dosage: acute 5 to 15 minutes
MICROWAVE DIATHERMY APPARATUS
 How is microwave produced?

Direct
Direct current (DC) is shunted to the cathode in
the magnetron valve
Release
Release of electrons from the cathode to the
multi-cavity
cavity anode valve
Electrons
Electrons oscillate at predetermined frequency
High
High frequency alternating current is
transmitted along a coaxial cable
Coaxial
Coaxial cable transmits energy to a director
 Fate of Microwave

Absorbed
- energy is taken up by the material
Transmitted
- pass through the material without being
absorbed
Refracted
- direction of propagation is altered
Reflected
 THERAPEUTIC EFFECTS

Increased blood flow or circulation to the

area
Increased tissue temperature
Increased metabolism
Facilitate relaxation
Increased pain threshold
Decreased blood viscosity
INDICATIONS

Soft tissue injury

Mobilization
Pain relief
CONTRAINDICATIONS

Pacemakers Malignant CA
Metal implants Active TB
Impaired Fever
sensation Thrombosis
Pregnancy X-ray exposure
Hemorrhage Uncooperative
Ischemic Tissue patient
Testicles and eyes Areas of poor
 PRECAUTIONS

Operator should observe caution when

handling the machine: same
contraindications apply
Production of Microwave:
- Produced by high frequency current and have
same frequency as the currents which
produce them
- Not produced by Oscillators/ Vacuum tube
valves / Solid state devices
Magnetron:
- Consists of cylindrical cathode surrounded by
an anode structure with cavities opening into
the cathode Anode space by means of slot.
 O/P energy is derived from the resonator
system by means of a coupling loop forced
into one of the cavities.
The energy picked up on the coupling loop is
carried out of the magnetron on the central
conductor of a co-axial
axial o/p tube throgh a glass
seal to the director
Director has radiating element of antenna
Electrical current transformed to antenna &
emits EM radiation. Then a reflector which
direct energy to the patient.
Components of Microwave Diathermy

Main supply voltage

Interference Suppression filter( Bypass the
high frequency pick up generated by
Magnetron)
Fan motor connected with power supply (
Used to cool magnetron)
Delay Circuit

Magnetron has to warmup for 3 to 4 minutes

before power may be delivered from it
Delay ckt connects the anode supply to the
magnetron after this time elapse
Lamp lights up after 5 minutes For indicates
that apparatus is ready to use
Magnetron Circuit

Filament heating voltage is obtained directly from the

secondary winding of the transformer
Cathode circuit contains suppression filters
Anode supply may be DC or AC.
DC voltage from full wave rectifier followed by voltage
doubler circuit
A high wattage variable resistance in series controls current
applied to the anode circuit
 AC voltage is applied to the anode of the
through series connected thyrotron sothat AC
voltages of both tubes are equal in phase.
The amount of the current through the
magnetron /output power can be varied by
shifting the phase of the control grid voltage
with respect to the phase of the anode
voltage
Phase shift can be achieved By using
capacitor resistor network.
Safety circuit

Fuse(500 mA) in the anode supply circuit

Large self inductance coils in primary supply
supply For
considerable interference
Due to small dimensions cores become saturated-
to avoid that coils are split up in such a way that no
magnetization
Duration of irradiation 10 to 25 minutes.
Skin should be dry as these waves are absorbed by
water.
Electrotherapy

i-tt curve
First stimulated with long impulses ( first 1s pulse
duration then 0-05ms)
For each impulse duration the current intensity is
adjusted until the stimulation threshold has been
exceeded.
So the current intensity has to be achieved to keep
threshold value
Impulse Duration(1000-300
300-100-10-3-1-0.05ms)
Chronaxie Period:
Minimum duration of impulse that will
produce a response with a current of double
of the rheobase
Rheobase:
Minimum intensity of current that will
produce a response if the stimulus is of finite
duration
Galvanic current
Steady flow of direct current
Movement of ions and their collection at the
skin areas lying beneath the electrodes
Bright red coloration due to increased blood
flow
For atonic Paralysis, for treatment of
disturbance in blood flow, iontophoresis
Current intensity 0.3 to 0.5 ma/sq.cm
Duration : 10-20 minutes
Faradic current

Sequence of pulses with defined shape & current

intensity
Pulse duration 1minute
minute triangular waves with
interval 20 minutes
Acts upon muscle tissue and upon the motor nerves
to produce muscle contractions
No ion transfer & No chemical effect
Treatment of muscle weakness after immobilization
and disuse atrophy & functional paralysis treatment
Surging current

Peak current increases & decreases

rhythmically & the rate of increase and
decrease of peak amplitude is slow
Surge rate: 6-60 surges / minute
Ratio of interval to the duration of surging is
varied
For the treatment of spasm and pain
Exponentially progressive
current
For the treatment of severe paralysis
Possibility of providing selective stimulation
Slope of the exponential pulse is varied
Biphasic Stimulation
Stimulating pulse is followed by a pulse of
opposite polarity of 1/10th amplitude & 1o
times the width
Neutralize the polarization of the electrodes
Multivibrators role in Functional
Electrical simulation
M1 Set basic stimulus Frequency. Variable rate MV Trigger M2
M2 Monostable MV sets the pulse width-
width Provide an interrupted
Galvonic output (Rate and duration can be controlled
M4 Astable MV- produces short duration faradic current
M3 Faradic current modulated at the frequency set by M1-M1 output
is surged faradic ( Slow rate of increase and decrease in intensity)
By integrating the output of M2 interrupted galvanic pulses can
be modified to have an exponential rise and fall
 Galvonic current By suitably tapping the DC
supply
Selector switch to emitter follower stage To
Low impedance constant voltage output
Floating type isolated from earth
Isolation transformer or RF Coupling
Different types :
Constant voltage / constant current type
Advantages of Constant current
Therapy

Current flow is constant irrespective of the

patients resistance
Distortion free
Avoids irradiating stimulatory sensation
between electrodes by keeping electrodes
firmly to the skin and in one position
Interferrential Current therapy

Fixed Frequency 4000 Hz

Second adjustable Frequency: 4001 4400 Hz
By Heterodyning Interference frequency is
created
Concentrated at the point of intersection
between the electrodes
Current perfuse over the greater depth and
over a larger volume of tissue then other
forms of electrical therapy
 At interferential range ( 4000Hz) Rsistance is
80 times lower at 50 Hz(in conventional
system)
So current crosses the skin easily with less
stimulation
Tolerable Dosage can be increased
To deep structures
Equipment Details

2 Channel + 4 electrodes ( In Quad Polar

arrangement
Each channel Sinusoidal symmetrical a.c at
high Frequency (2000-- 5000Hz)
Both undergone constructive and Destructive
Interference