SHORTWAVE & MICROWAVE

DIATHERMY
General Information

Another form of deep heat

Out of favor with the PT community for the
last several years.
In general shortwave diathermy is effective
for deep heating of deeper structures.
Microwave diathermy has been used for
smaller body parts such as the hands
Penemuan biolistrik

Caldani (1856)
Kelistrikan pada otot katak yang telah mati
Luigi Galvani
1780 mulai mempelajari kelistrikan pada
tubuh hewan
1786 kedua kaki katak terangkat ketika
diberikan aliran listrik melalui
konduktor
Penemuan biolistrik

Arons (1892)
Merasa ada aliran frekuensi tinggi melalui tubuhnya
sendiri
Van Seynek (1899)
mengamati terjadinya panas pada jaringan yang
disebabkan aliran frekuensi tinggi
Schlephake (1982)
Pengobatan dengan menggunakan Short Wave
Rumus/ Hukum dalam Biolistrik

Hukum Ohm
Perbedaan potensial antara ujung konduktor
berbanding langsung dengan arus yang melewati,
berbanding terbalik dengan hambatan dari
konduktor

R=V R = Hambatan (/ohm)

I V = Tegangan (volt)
I = Arus (ampere)
Rumus/ Hukum dalam Biolistrik

Hukum Joule
Arus listrik yang melewati konduktor dengan
perbedaan tegangan dalam waktu tertentu akan
menimbulkan panas.
V = tegangan (Volt)
H (kalori) = VIT I = arus (Ampere)
J T = Waktu (detik)
J = Joule = 0,239 kal
Penggunaan Listrik & Magnet
pada permukaan Tubuh
Jacques A.D. Arsonval
1890 listrik berfrekuensi rendah efek pemanasan
1929 listrik frek. 30 MHz short wave diathermy
1950 gel mikro frek 2450 MHz diatermi & pemakaian
radar
Arus listrik berdasarkan efek yang ditimbulkan:
1. Listrik berfrekuensi rendah (20 500.000 Hz)
merangsang saraf & otot sehingga terjadi kontraksi otot
stimulator dengan multivibrator -astable multivibrator
* pengulangan pemakaian dan pemilihan bentuk gelombang
perlu diperhatikan
Penggunaan Listrik & Magnet
pada permukaan Tubuh
2. Listrik berfrekuensi tinggi (> 500.000 Hz)
Belum merangsang saraf motoris & sensoris
Sifat : memanaskan
* Short wave diathermy (diatermi gel. Pendek) untuk
memperoleh gel. Elektromognetis agar masuk ke dalam tubuh
dengan 2 metode: capasitance (kondensor) & inductance
(induksi= kabel)
Metode kondensor
Prinsip : elektroda diletakkan pada masing-masing sisi yang
akan diobati & dipisahkan dari kulit dengan bahan isolator
Metode isolasi/ kabel
kabel dililitkan pada daerah yang akan diobati
Body Heat Compositin
Temperature Receptors
Objectives

Explain the physiologic effects of diathermy

Identify the application, indications,
contraindications, and precautions for
treatment with diathermy
List the major differences between
microwave and shortwave diathermy
Terminology

Diathermy
Application of high frequency electrical energy
used to generate heat in body tissue as a result of
the resistance of the tissue to the passage of
energy
Also used to produce non-thermal effects
Can be applied to heat larger areas of deep tissues
than ultrasound, and physiological effects are the
same
Dont Call it a Come Back

Not widely used for many reasons

Interference with sensitive electronics
Duplicate expense
Not aggressively marketed by equipment
manufacturers
Recent increase in utilization and in interest
New publications
New equipment
Physiologic Effects

Thermal
Similar to other deep heat modalities
Increased blood flow/vasodilation
Increased local metabolic rate
Increased soft tissue extensibility
Pain relief
Physiologic Effects (Cont.)

Non-thermal
Pulsed shortwave
Injury alters cell membrane potential
Depolarization
Diminished sodium pump activity
PEME said to repolarize cell membrane and
reactivate sodium pump
Types of Diathermy:
Shortwave
Three assigned frequencies
(FCC)
27.12 MHz (wave=11M)
13.56 MHz (wave=22M)
40.68 MHz (wave=7.5M) (rarely
used)
Generated with power
supply, radio frequency
oscillator, power amplifier,
and output resonant tank
Types of Diathermy:
Shortwave
Much like ultrasound, treatment should be
adjusted to elicit specific results (i.e.- tissue
temp increases) rather than standard
protocols
Most units can produce between 80-120W of
power
Dosage guidelines:
Dose I: No sensation of heat
Dose II: Mild heat sensation
Dose III: Moderate heat sensation
Dose IV: Vigorous heat, below pain threshold
Types of Diathermy:
Shortwave
Tuning
Automatic on most newer units
Manual on older units
Adjust intensity to 30-40%
Adjust tuning control for peak output
Readjust intensity to at or below 50%
Types of Diathermy:
Shortwave
Delivery
Capacitance
Stronger electrical field
than magnetic
Patient is part of the
circuit
Subcutaneous fat a factor
Air space plates most
frequently used
Pad electrodes also used
Types of Diathermy:
Shortwave
Delivery (continued)
Induction
Stronger magnetic than electrical
field
When current passed through a
coiled cable, magnetic field
results, which also triggers eddy
currents
Patient is NOT part of the circuit,
but rather in a magnetic field
Subcutaneous fat not as
important
Types of Diathermy:
Shortwave
Delivery (continued)
Induction
Cable electrodes
Pancake and wraparound
Use toweling
Drum electrodes
Easier & more consistent
Use toweling to absorb sweat &
avoid overheating
May penetrate up to 3 cm
Types of Diathermy: Pulsed
Shortwave
PEME, PEMF, or PEMET
Uses drum electrodes
Used for non-thermal effects
Usually off time considerably longer than
on time
Typical treatment times range between 15-
30 minutes
Check for rebound vasocinstriction if
treatment lasts longer than 30 minutes
Pulsed Shortwave Diathermy

Pulsed electromagnetic energy (PEME)

Pulsed electromagnetic field (PEMF)
Pulsed electromagnetic energy treatment
(PEMET)
Types of Diathermy:
Microwave
2456 MHz or 915 MHz
Generate strong electrical
with minimal magnetic field
Electrodes referred to as
applicators and may be
round or rectangular
Best for low fat areas, as
does not penetrate as
deeply as shortwave
Types of Diathermy:
Microwave
Keep metal and sensitive
electronics at least 4 feet
away
Shortwave appears to be
safer
Diathermy Application

Indications
Sub-acute strains, sprains, trigger points,
inflammation/irritation
Tenderness which makes moist heat and/or
ultrasound undesirable
Large areas where deep heat is desired
Application
Always use towelling
Diathermy Application

Contraindications and precautions

Same as ultrasound
Metals
Sensitive electronics
Pacemakers
Pregnancy