The History of SWD Production, Generation, Method of Application, Patient Preparation, Physiologcal and therapeutic effects, Indications, Contraindications daners of SWD, and Evidence Based Practice.

2. Dr. Muhammad Umair Shaikh
Hassaan Bin Nasir
Syeda Afshan Naz
Sana Kayenat
Khadija Usman
Batool Hassan
Presenters:
Presented To:

4. HISTORY
Serbian American
engineer Nikola
Tesla first noted around
1891 the ability of high
frequency currents to
produce heat in the body
and suggested its use in
medicine
1899 Austrian chemist
von Zaynek determined
the rate of heat
production in tissue as a
function of frequency and
current density, and first
proposed using high
frequency currents for
deep heating therapy

5. HISTORY
In 1908 German physician Karl Franz
Nagelschmidt coined the term diathermy,
and performed the first extensive
experiments on patients. Nagelschmidt
is considered the founder of the field. He
wrote the first textbook on diathermy in
1913, which revolutionized the field.
Until the 1920s noisy spark-discharge
Tesla coil machines were used. These
were limited to frequencies of 0.1 - 2 MHz,
called "longwave" diathermy. In the 1920s
the development of vacuum
tube machines allowed frequencies to be
increased to 10 - 300 MHz, called
"shortwave" diathermy.

6. DEFINITION
Shortwave means the application of high
frequency electrical energy to the body
tissues in order to bring physiological and
therapeutic effects, these effects can be
achieved by thermal or non thermal effect.

7. FREQUENCY
 27.12 MHz, wavelength 11 M (most
common used one).
 13.56 MHz wavelength 22 M.
 40.68 MHz 7.5 M.
Shortwave Has Three Main Frequencies:

8. Production Of SWD
1. Machine or Oscillatory Circuit or
Condenser Field Method
2. Patient or Resonator Circuit or
Inductothermy or Cable Wire Method.

9. 1. Machine or Oscillatory Circuit
or Condenser Field Method
o Consists of condenser, inductance
o Currents of different frequencies are
obtained by Selecting suitable
condenser and inductance.
o If a current of high frequency is
required, the condenser and inductance
are very small. While to produce a
current of lower frequency a larger
condenser and inductance is used.
Production Of SWD
2. Patient or Resonator Circuit
or Inductothermy or Cable
Wire Method.
Machine circuit is coupled with the
patient circuit, Converts the electrical
Energy in Electromagnetic Energy Via
Eddy Current.
The Eddy current is produce ┴ or ‘L’
toward electric line of forces, results
in the production of Sup, heat.

10. METHODS OF APPLICATION
&
PREPARATION OF PATIENT:
SYEDA AFSHAN NAZ

11. Methods Of Application:
1. Condenser Field Method
2. Cable Method

12. Condensor Field Method:
1- Contraplanar Method:
2- Coplanar Method:
3- Cross fire Method:
4- : Monopolar Method

13. 1- Contraplanar Method:
• It is the most satisfactory method, especially for the treatment of deeply-
placed structures.
• In this method the Electrodes are placed in opposite direction around the
body area which has to be treated.
• A uniform production of electrostatic force is produced which results into
deep heat as compare to superficial heat.
• Mostly Use for the treatment of Ankle and Shoulder, etc.

14. 2- Coplanar Method:
• In this method, electrodes are placed side by side on the same aspect of the
part, provided there is an adequate distance between them.
• The distance between the two electrodes should be more than the total width
of spacing.
• In this method, the heat is more superficial and suits certain areas such as
the spine, where one electrode is placed over the dorsal region, while the other
placed over the lumbar one.
• Mostly use for Low Back Pain.

15. • In this Method, half of the treatment period is given with the electrodes in
one position and then they are moved to be at right angle to that obtained
during the first part of the treatment.
• For example, for the knee joint, during the first half of the session, the
electrodes are placed on the medial and lateral aspects of the knee. On the
opposite, during the second half of the session, the electrodes are transferred
to the anterior and posterior aspects of the knee.
• Mostly use for Sinuses and Knee joint.

16. Monoplanar Method
• The active electrode is placed over the site of the lesion,
while the indifferent one is applied to some distant part of the
body.
• This method is used for very superficial lesions (face and
sinuses).

17. Cable Method:
1. Arrangement at the Ends of Cable
2. Arrangement through Center of Cable
3. Grid Arrangement

19. Patient Preparation:
 Ensure that patient is free of all
contraindications and The patient must be
comfortable and the part to be treated should be
fully supported.
 Remove all Jewelry, coins, other metallic items
from the patient.
 The treatment tissue should not be covered by
clothing.
 Wash the skin over treatment area, thoroughly
dry the skin prior to treatment.

20. Conti..
 For personal safety, the therapist should remove rings,
watch, bracelets and so on.
 Treatment should be on a couch, chair or a table, which
must be wooden and free from metals.
 The skin must be dry.
Skin sensation must be tested before treatment starts.

21. Monitoring the Treatment:
• Before starting treatment, all meters of the apparatus should be on zero
position (the starting position).
• Select the power level according to the patient’s condition.
• Increase the intensity gradually till the desired heating level is reached.
• Immediately check for any complaint of hot sensation.
• The physical therapist should remain within call of the patient during
the whole treatment period.
• At the end of treatment, the control knobs are returned to zero position,
current switched off and the electrodes removed.

22. PHYSIOLOGICAL EFFECTS
Sana Kayenat

23. Physiological Changes
• When a high frequency alternating
current is applied, it increases the
internal kinetic energy of matter
causes heating and increase
temperature in the material.
• SWD produces heat through tissue
by:
Vibration of charged molecules
Rotation of dipolar molecules
Distortion of non-polar molecules

24. Charged Molecules
 Ions and certain proteins.
 Heat energy will be
generated due to rapid
vibrations of ions, rapidly
changing electrostatic
field.
 Most efficient way of heat
production

25. Dipolar Molecules
 Water and some proteins
 Positive pole of the molecule
aligns itself to the negative pole
of the electric field (vice versa) by
rapidly rotating.
 Moderately efficient heat
production.

26. Non Polar Molecules
o Many of the non polar molecules like
fats and lymphatics can cause
distortion of polar molecules which
results in less deep heating and more
superfacial heating.
o Least efficient heat production

27. Physiological Effects:
The effects that are produced in the body due to heat
are as follows:
1. Effects on Metabolism
2. Effects on Blood vessel
3. Effect on Temperature
4. Effects on Sweat glands
5. Effects on Blood pressure

28. Effect on Metabolism:
• A/c to Vantt Hoff’s law The rise in temperature can
increase the rate of metabolism.
• The increase in metabolism is greatest in tissues
where most heat is produced.
• As a result of increase metabolism, there is a
increased demand for oxygen and foodstuffs and an
increased output of waste products including
metabolites.

29. Effects on blood supply
• As a result of increased output of waste products such
as metabolites, which act on the walls of the capillaries
and arterioles, these tissues dilate.
• In addition, heat has direct effect on blood vessels,
causing vasodilatation.
• Heat also produces stimulation of superficial nerve
endings, causing reflex dilatation of the arterioles.

30. Effect on temperature
Effect on Sweat Glands
• As blood passes through the heated tissues, it also
becomes heated and carries the heat to other body parts.
• Rise of temperature induces muscle relaxation and
increases the efficiency of muscle action.
 If a general rise of temperature occurs, hypothalamus receptors of
the brain detect increase in temperature thus results in increase
activity of the sweat glands.

31. Effect on Blood Pressure
• The generalized vasodilatation reduces the
peripheral resistance to blood flow.
•Heat also reduces blood viscosity, which helps in
the reduction of blood pressure.

32. Therapeutic Effects
1.Effect on bacterial infection
SWD increases the circulation of blood which
increases the number of WBC and antibodies in the
affected region which help in removing infection.
2.Effect on healing time
The beneficial effect of SWD in traumatic conditions
includes fluid exudation, increased blood flow, removal
of waste products etc. The increased blood flow makes
more nutritive material therefore assist in healing
process.

33. Cont..
3.Relief of Pain
• The mechanism of pain relief is explained by:
• Sedative effect due to mild degree of heating
• Removal of noxious chemical (waste products of
metabolism)
• Counter irritation effect due to superficial heating which
block the pain transmission at pain gate.
• Relief of pain also accompanies resolution of inflammation
by SWD.

34. Cont..
4.Induction Of Muscle Relaxation:
When SWD applied over spasmodic muscle in inflammatory and
traumatic conditions induces muscle relaxation and reduces pain.
5.Fibrosis:
Application of SWD increases the extensibility of fibrous tissues
such as tendon, scars, and joint capsule by 5 to 10 times.

35. Indications of SWD
KHADIJA USMAN

36. EFFECTS ON INFLAMMATION

37. EFFECTS IN BACTERIAL INFECTIONS

38. TRAUMATIC CONDITIONS

39. RELIEF OF PAIN

40. DISORDERS OF MUSCULO SKELETAL SYSTEM
sprain and strain
Muscle and tendon tear
Haematoma
Capsular Lesion

41. REMOVE TRIGGER POINT

42. DRAINAGE OF SINUSES

43. ARTHRITIS

44. CONTRAINDICATIONS
OF SWD

45. HAEMORRHAGE

46. VENOUS THROMBOSIS

47. ARTERIAL DISEASE

48. METALIC IMPLANT

49. DISTURBED SKIN SENSATION

50. TUMOURS

51. Rheumatoid arthritis

52. EPILEPTIC PATIENTS

53. CARDIAC PACEMAKER

54. X-ray THERAPY

55. PREGNANCY

56. Dangers:
1. Burns
2. Scalads
3. Electric shock
4. Overdose
5. Faintness
6. Giddiness
7. Precipitation of gangrene

57. Evidence Based
Practice
BATOOL HASSAN

58.  Cetin N, Aytar A,
Atalay A, Akman MN
performed a research
“Comparing hot pack,
short-wave
diathermy,
ultrasound, and
TENS on isokinetic
strength, pain, and
functional status of
women with
osteoarthritic knees”
a blind randomized
controlled trial.
 Pain and disability
index scores were
significantly reduced
in each group. But
patients in group with
SWD followed by
isokinetic exercise
showed greater
increases than other
groups in muscular
strength at all angular
velocities.
 In most
parameters,
improvements were
greatest in groups 1
compared with
groups 2, 3 and 4.

59. Nisha Shinde and Shinde Kiran Jayawant conducted a research in
2010 “Efficacy of Short Wave Diathermy in Patients with
Sinusitis”.
With the presented findings for the relief of signs and symptoms also
the reduction of pain we can state that there was almost same effect
for the treatment of sinusitis with only either routine medical
treatment or SWD.
But when it is applied with combination of both i.e. routine medical
treatment and SWD gives more benefit and earlier effect with little or
no recurrence of the sinusitis.

60. Sikiru Lamina, Shamaila Hanif and Yusuf Saidu
Gagarawa performed a research in 2009 on “Short Wave
Diathermy in the symptomatic management of
Chronic Pelvic Inflammatory Disease Pain.”
It was concluded that SWD is an effective and non
invasive therapy in the management of chronic PID pain.

61. Jan MH, Chai HM and Wang CL conducted a research in
2006 on “Effects of repetitive shortwave diathermy for
reducing synovitis in patients with knee osteoarthritis”
an ultrasonographic study.
After 10 SW diathermy treatments, the total synovial sac
thickness in both treatment groups was significantly less
than the initial thickness, and the synovial sac continued to
become significantly thinner with 20 sessions of treatment.
These observations were not made in the control subjects.

62. “THANK YOU SO MUCH ANY QUESTION…?